2009 2 Supliment

REVISTA ROMN DE
MEDICIN DE LABORATOR
Supliment la Vol. 15, Nr. 2, Iunie 2009
Refereni tiinifici
Professor Vladimir Palicka, MD, PhD Prof. Univ. Anca Cristea
(Univ. Hradek Kralove, Praga, Czech Republic) (UMF Iuliu Haieganu Cluj)
Professor Elizabeta Topic, MD, PhD Prof. Univ. Dr. Olga Dorob
(Univ. Zagreb, Croatia) (Institutul Naional de Boli Infecioase Matei Bal)
Professor Gabor Kovacs, MD, PhD Prof. Univ. Dr. Simona Stolnicu
(Univ. Pecs, Hungary) UMF Tg. Mure)
Professor Lszl Muszbek, MD, PhD Prof. Univ. Dr. Victor Pop
(Univ. Debrecen, Hungary) (UMF Iuliu Haieganu Cluj)
Professor Patrice Andr, MD, PhD Conf. Univ. Dr. Adriana Coli
(Univ. Claude Bernard Lyon 1, France) (UMF Carol Davila Bucureti)
Dr. Viliam Lustig, PhD, FCACB Conf. Univ. Dr. Didona Ungureanu
(Univ. of Toronto, Canada) (UMF Gr. T. Popa Iai)
Ass. Professor Connie Prosser, PhD Conf. Univ. Dr. Ileana Constantinescu
(Univ. of Alberta Hospital, Edmonton, Canada) (Institutul Clinic Fundeni)
Trefor Higgins, MSc, FCACB Conf. Univ. Dr. Irina Codi
(Dynacare Kasper Medical Laboratories, Edmonton, (UMF Carol Davila Bucureti)
Canada) Conf. Univ. Augustin Curticpean
Ass. Prof. Manuela G. Neuman (UMF Tg. Mure)
(Institute of Drug Research, Univ. of Toronto, Canada) Conf. Univ. Marius Mruteri
Alexandru chiopu, M.D., PhD (UMF Tg. Mure)
(Lund University, Malm, Sweden) Conf. Univ. Silvia Imre
Prof. Univ. Dr. Mircea Cucuianu (UMF Tg. Mure)
(UMF Iuliu Haieganu Cluj) Conf. Univ. Dr. Camil Vari
Prof. Univ. Dr. Dan Coli (UMF Tg. Mure)
(UMF Carol Davila Bucureti) Conf. Univ. Dr. Andrei Cucuianu
Prof. Univ. Dr. Marian Negu (UMF Iuliu Haieganu Cluj)
(UMF Carol Davila Bucureti) Conf. Univ. Dr. Ioana Brudac
Prof. Univ. Dr. Eugen Carasevici (UMF Iuliu Haieganu Cluj)
(UMF Gr. T. Popa Iai) Conf. Univ. Maria Dronca
Prof. Univ. Dr. Margit erban (UMF Iuliu Haieganu Cluj)
(UMF Victor Babe Timioara) Conf. Univ. Dr. Felicia Toma
Prof. Univ. Dr. Hortensia Ioni (UMF Tg. Mure)
(UMF Victor Babe Timioara) Conf. Univ. Dr. Lilla-Katalin Lorinczi
Prof. Univ. Dr. Roxana Moldovan (UMF Tg. Mure)
(UMF Victor Babe Timioara) Conf. Univ. Dr. Lucian Pucaiu
Prof. Univ. Dr. Gheorghe Gluhovschi (UMF Tg. Mure)
(UMF Victor Babe Timioara) Conf. Univ. Dr. Vlad Gorduza
Prof. Univ. Dr. tefan Hobai (UMF Gr. T. Popa Iai)
(UMF Tg. Mure) ef Lucrri Dr. Andreea Moicean
Prof. Univ. Dr. Ioan Pascu (UMF Carol Davila Bucureti)
(UMF Tg. Mure) ef lucrri Ionela Pacanu
Prof. Univ. Dr. Marius Sabu (UMF Tg. Mure)
(UMF Tg. Mure) Asist. Univ. Dr. Gabriel Ionescu
Prof. Univ. Dr. Monica Sabu (UMF Carol Davila Bucureti)
(UMF Tg. Mure) Asist. Univ. Dr. Vladimir Bacrea
Prof. Univ. Dr. Alexandru chiopu (UMF Tg. Mure)
(UMF Tg. Mure) Asist. Univ. Dr. Camelia Dobrea
Prof. Univ. Dr. Angela Borda (UMF Carol Davila Bucureti)
(UMF Tg. Mure) Asist. Univ. Dr. Adriana Mihai
Prof. Univ. Dr. Galafteon Oltean (UMF Tg. Mure)
(UMF Tg. Mure) Dr. Dan Oelea
Prof. Univ. Dr. Minodora Dobreanu (Institutul Naional de Boli Infecioase Matei Bal)
(UMF Tg. Mure) Dr. Cornel Ursaciuc
Prof. Univ. Dr. Dan Dobreanu (Institutul Naional Victor Babe)
(UMF Tg. Mure) Dr. Mariana Paiu
(Institutul Oncologic Ion Chiricu, Cluj)
ASOCIAIA LABORATOARELOR MEDICALE DIN ROMNIA
Aleea Barajul Uzului 2, Bl. Y 16, Sc. A, Apt. 18, Sector 3
RO-032796, BUCURETI
Tel 4021 340 76 68
O.P. 60, C.P. 18., Sector 3, Bucureti
www.rrml.ro, www.almr.ro
REVISTA ROMN DE
MEDICIN DE LABORATOR
Publicaie oficial a ASOCIAIEI LABORATOARELOR MEDICALE DIN ROMNIA
Supliment la Vol. 15, Nr. 2, Iunie 2009
Comitetul de redacie
Comitet redacional
Redactor ef Chim. Dr. Ileana Funduc
Prof. Univ. Dr. Minodora Dobreanu (Vicepreedinte ALMR)
(Preedinte ALMR) Conf. Univ. Dr. Ileana Constantinescu
(Vicepreedinte ALMR)
Redactor adjunct Chim. Sorin Gju
Dr. Liviu Sorin Enache (Vicepreedinte ALMR)
Dr. Elena Luminia Enache
Traductor As. Univ. Dr. Anca Bacrea
Dr. Cosmin Moldovan As. Univ. Dr. Andrea Marta Fodor
As. Univ. Dr. Edit Szkely
Creditri RRML
Thomson Reuters Scientific ISI Web of Knowledge
ncepnd cu anul 2008, RRML este indexat n ISI Web of Knowledge Web of Science - Science Cita-
tion Index Expanded (Thomson Reuters Scientific).
CNCSIS
n urma evalurii din luna decembrie 2008, RRML este recunoscut de ctre CNCSIS (categoria A) cu
codul CNCSIS 739.
CMR
Prin adresa Nr. 3218/09.06.2008 a Departamentului Profesional - tiinific al CMR, RRML a fost in-
trodus n Nomenclatorul Publicaiilor Medicale al CMR pentru anul 2008. Medicii abonai la aceast publicaie
sunt creditai cu 5 credite EMC.
OBBCSSR
Prin adresa Nr. 1779/28.02.2007, OBBCSSR a creditat RRML cu 7 credite EMC.
1st Congress of the Romanian Association of
Medical Laboratories
with International Participation
Under the auspices of IFCC and EFCC
24 - 27 June 2009, Trgu Mure, Romania
Abstract Book
ORGANIZERS
Romanian Association of Medical Laboratories

University of Medicine and Pharmacy Trgu Mure
Romanian Society of Microbiology
Romanian Society of Hematology
ORGANIZING COMMITTEE
Trgu Mure Lilla Lrinczi
Minodora Dobreanu (RAML President) Edit Szkely
Liviu Sorin Enache Anca Mare
Elena Luminia Enache Adrian Man
Andrea Mrta Fodor Bianca Tudor
Anca Bacrea Ionela Pacanu
Monica Badiu Katalin Csp
Andreea Tru
Annamaria Fldes Bucharest
Felicia Toma Ileana Funduc (RAML Vice-president)
Ariadna Rdulescu
SCIENTIFIC COMMITTEE
Prof. Mircea Cucuianu Prof. Olga Dorob
Prof. Dan Coli Ass. Prof. Didona Ungureanu
Prof. Marian Negu Ass. Prof. Ileana Constantinescu
Prof. Eugen Carasevici Ass. Prof. Irina Codi
Prof. tefan Hobai Ass. Prof. Augustin Curticpean
Prof. Ioan Pascu Ass. Prof. Marius Mruteri
Prof. Marius Sabu Ass. Prof. Silvia Imre
Prof. Monica Sabu Ass. Prof. Camil Vari
Prof. Alexandru chiopu Ass. Prof. Andrei Cucuianu
Prof. Angela Borda Ass. Prof. Ioana Brudac
Prof. Klara Brnzaniuc Ass. Prof. Felicia Toma
Prof. Galafteon Oltean Assistant Gabriel Ionescu
Prof. Minodora Dobreanu Mariana Paiu, MD, PhD
Prof. Anca Cristea
SPONSORS
Principal Sponsors:
ABBOTT Diagnostics
NOVAINTERMED
BIOCLINICA
Major Sponsors:
CLINILAB
ROCHE Diagnostics
ROCHE Pharma
PROTON
DIAMEDIX
NOVA GROUP INVESTMENT
Official Sponsors:
BALMED
TEHNO INDUSTRIAL
AVENA MEDICA
PALMED PATRONAT
CARL ZEISS INSTRUMENTS
MEDIA PARTNER
SPTMNA MEDICAL
Revista Romn de Medicin de Laborator, Supliment la Vol. 15, Nr. 2, Iunie 2009 9
Table of contents
Cuprins
Table of contents......................................................................................................................................9
Cuprins...................................................................................................................................................9
ABSTRACTS.........................................................................................................................................11
REZUMATELE LUCRRILOR.........................................................................................................11
Automation and analytical techniques.............................................................................................11
Hematology 1...................................................................................................................................13
Hematology 2...................................................................................................................................17
Genetics............................................................................................................................................21
Haemostasis.....................................................................................................................................34
Microbiology ...................................................................................................................................37
Molecular Biology ...........................................................................................................................50
Clinical Chemistry 1........................................................................................................................52
Clinical Chemistry 2........................................................................................................................57
Immunology .....................................................................................................................................63
Posters 1. Microbiology ..................................................................................................................70
Posters 2. Microbiology ..................................................................................................................84
Posters 3. Immunology ....................................................................................................................95
Posters 4. Biochemistry .................................................................................................................118
Authors index.......................................................................................................................................141
Index de autori....................................................................................................................................141
Information and Guidelines for Authors...........................................................................................147
Authorship responsibilities.................................................................................................................153
ABSTRACTS*
REZUMATELE LUCRRILOR
Automation and analytical techniques

R2. Laboratory consolidation and automation: results after two years of
experience
Liszt Ferenc
Institute of Laboratory Medicine, University of Pecs, Hungary
The management of the Institute of Laboratory Medicine, the provider of clinical laboratory
(clinical chemistry, hematology, hemostasis, immunology, molecular diagnostics, etc.) services of the
tertiary care University Hospital has decided in 2006 to undergo the laboratory renewal procedure.
Right from the start, consolidation was a key aspect of our plan to create an automated, multi-disciplin-
ary core laboratory. The MODULAR ANALYTICS package comprises three MOD Analytics P units,
three MOD Analytics E units and a full MOD PREANALYTICS (MPA) with twin centrifuges. With
the installation of MPA the laboratory information system had to be renewed, to fulfill the traceability
requirements from sampling through analytic to archiving. The goals of this project were to increase
quality, to enhance service for clinicians with shortened turnaround time with less laboratory staff.
In the lecture, the author will discuss the phases of consolidation and automation process and
major stages of the implementation of the quality assurance system (fulfilled the the requirements of
ISO 15159:2007 and ISO/IEC 17025:2005 standards) and some economic point of view as well.
R3. Pitfalls in the performance and interpretation of some clinical

immunological tests
Cristea Anca1, Bene Liliana2, Rahaian Rodica2
1. Iuliu Haieganu UMF Cluj-Napoca; 2. Clinical EmergencyHospital Cluj, Romania
We try to exemplify some potential pitfalls encountered in clinical immunology laboratory with
regard to immunochemistry, cellular immunology and autoimmunity. These observations are a direct
result of our experience. The main causes of errors are the quality of the sample, the quality of the re-
agents or both, the poor understanding of the assay and, last but not least, the modality of delivery the
results to the clinicians. All these may conduct to misinterpretation of the assay and finally to misdia-
gnosis.
*
The responsibility for the content of the abstracts belongs entirely to the authors.
12 Revista Romn de Medicin de Laborator, Supliment la Vol. 15, Nr. 2, Iunie 2009
Pitfalls may also be due to the deficiency of external quality control at national level, for all
fields of clinical immunology. We propose a management system to examine the interpretation and re-
porting the results of immunology laboratory tests.
Erori n executarea i interpretarea unor teste de imunologie clinic

Cristea Anca1, Bene Liliana2, Rhian Rodica2
1. UMF Iuliu Haieganu Cluj-Napoca; 2. Spitalul Clinic Judeean de Urgen Cluj
Incercm s exemplificm cteva din erorile care pot exista n practica laboratorului de imunolo-
gie (imunochimie, imunitate celular, autoimunitate) i care pot afecta calitatea rezultatelor. Obser-
vaiile sunt rezultatul experienei noastre de lung durat. Cauza principal a erorilor poate fi datorat
calitii probei i/sau a reactivilor, nelegerea insuficient a principiilor i a valorii testului, i nu n ul-
timul rnd, a modalitii de a elabora rezultatul pentru clinician. Toate acestea pot duce la o interpretare
greit a analizei i n final la un diagnostic greit.
O mare parte din erori pot fi datorate lipsei unui control de calitate extren la nivel naional pentru
toate domeniile imunologiei clinice. Propunem un sistem de management pentru a examina modalitatea
de raportare i interpretare a rezultatelor testelor imunologice.
R4. Inhibitors of stem cell factor binding to its receptor c-Kit -

a computational study
Hobai tefan
Dept. of Medical Biochemistry, University of Medicine and Pharmacy Tirgu Mures, Romania
Stem-cell factor (SCF) is an early-acting hematopoietic cytokine which, as noncovalent homodi-
mer, stimulates the proliferation of mast cells, melanocytes, and primitive hematopoietic progenitors. It
exerts biological effects by binding to the cell surface receptor c-Kit (CD117) which induces receptor
homodimerization. CD117 is encoded by the c-Kit proto-oncogene of which mutations are associated
with gastrointestinal stromal tumors.
Equipment & Methods. Model building, docking experiments (Glide application), energy min-
imization (Impact), and molecular dynamics (Impact and MacroModel) studies were carried out using
the software library Schrdinger, Suite 2008, with the graphical user interface Maestro. The dimeriza-
tion surface of SCF was studied in absence and presence of some ligands acquired from the National
Cancer Institute USA molecular database. It was performed by superimposition of the monomer crystal
structures, acquired from Protein Data Bank under code 1SCF, with those obtained by molecular dy-
namics simulation. The system was relaxed by Impact application using a conjugate gradient minimiz-
ation with equilibration at 300 K. Glide flexible docking procedure was applied to 22 aminoacids for
each homodimer subunit selected as flexible portion. Partitioning properties at pH = 7 of ligands were
estimated by the theoretical logD calculated with the MarvinSketch software to ascertain if the ligands
satisfy the Lipinskis rules.
Results. It was found that approximately 855 2 of surface area from each protomer is buried
into the dimer interface.
The dimer interface is characterized by two loop regions, respectively, constituted by residues
1726 (loop a) and 6172 (loop b). The root mean square deviation (RMSD) computed separately onto
the carbon atoms of both loops a and b revealed that the four monomers at the interface region were
conformationally well conserved. After the crystallographic subunits AD superimposition, the mo-
lecular dynamics run indicated the loop b is particularly subject to perturbation, more than a. A series
of 8 compounds, very divese in terms of chemical scaffolds, flexibility and lipophilicity, was selected
based on the ranking score.The most hydrophobic compounds showed a major role of vdW term with
respect to the electrostatic one between the attractive interaction contributions.
Conclusions. 1. The SCF dimerization negative modulation could be a selective target of preven-
tion of haematopoietic cancer activation. 2. The study of these dimer surface binding ligands should re-
veal selective drugs, better than nonspecific protein-tyrosine kinase inhibitors, such as STI-571
(Gleevec, also named Imatinib).
Hematology 1
C8. Cytogenetic and molecular response after dasatinib in blastic phase
chronic myeloid leukemia
Cucuianu Andrei, Dima Delia, Petrov Ljubomir
Ion Chiricuta Cancer Institute, Hematology Dept, Cluj-Napoca, Romania
Chronic myeloid leukemia (CML) in blastic phase carries an adverse prognosis. Small molecule
tyrosine kinase inhibitors may change the outlook in these patients. We present the case of a 62 year
old female who was diagnosed in March 2006 with chronic phase, Philadelphia positive CML. She was
initially treated with hydroxyurea with the achievement of a complete hematologic response (CHR) but
in July 2006 the patient progressed to blastic phase. Imatinib was started at 400mg/d and CHR was ob-
tained, but in November 2006, blastic phase CML relapsed. Imatinib 600mg/d was attempted but it was
poorly tolerated, while having no significant effect. Subsequently, the patient was started on dasatinib 2
x 70mg daily with the achievement of CHR after one month. A recurrent problem was bilateral pleural
effusion requiring evacuation and reduction of dasatinib to 100mg/d. Major cytogenetical remission
was obtained by 3 months and complete cytogenetical remission (CCR) by 6 months. RQ-PCR, per-
formed at 6 months showed a major molecular response (MMR). CCR and MMR were maintained at
18 and 24 months follow-up. Recurring pleural effusion, necessitating evacuation every 2-3 months,
fluid retention and cataracts were the main adverse effects. This case report underscores the progress
being made in recent years in the treatment of CML, even in advanced phases, due to the introduction
of tyrosine kinase inhibitors.
Rspuns citogenetic i molecular dup dasatinib n leucemia mieloid

cronic n faz blastic
Cucuianu Andrei, Dima Delia, Petrov Ljubomir
Ion Chiricuta Cancer Institute, Hematology Dept, Cluj-Napoca, Romania
Leucemia mieloid cronic (LMC) n faz blastic are un prognostic infaust. Introducerea re-
cent n practic a inhibitorilor de tirozin kinaze ar putea ameliora semnificativ prognosticul acestor
pacieni. Prezentm cazul clinic al unei paciente de 62 ani diagnosticat n martie 2006 cu LMC faz
cronic Philadelphia pozitiv. A fost iniial tratat cu hydroxiuree, obinndu-se un rspuns hematolo-
gic complet (RHC) dar n iulie 2006 boala a progresat spre faza blastic. S-a nceput tratament cu imat-
inib, 400mg/zi. Sub imatinib s-a obinut RHC dar n noiembrie 2006 s-a observat recidiva fazei
blastice. Creterea dozei la 600mg/zi a fost greu tolerat, fr efect semnificativ. Ulterior, s-a iniiat
tratament cu dasatinib 2 x 70mg/zi. Tratamentul a fost bine tolerat cu obinerea RHC dup o lun.
Efectul secundar principal a fost colecia pleural recidivant, necesitnd repetate evacuri i reducerea
dozei la 100mg/zi. Rspunsul citogenetic major a fost obinut dup 3 luni iar remisiunea citogenetic
complet (RCC) dup 6 luni. RQ-PCR, efectuat la 6 luni a relevat un rspuns molecular major (RMM).
RCC i RMM s-au meninut la bilanul de la 18 i 24 luni. Colecia pleural recidivant, necesitnd
evacuri la 2-3 luni, edemele i cataracta au fost principalele efecte adverse ale tratamentului. Acest
caz clinic subliniaz progresul realizat n ultimii ani n tratamentul LGC, chiar i n cazurile avansate,
datorit introducerii noilor inhibitori de tirozin kinaze.
C9. Cytogenetic analysis in malignant hematologic diseases in Tg. Mure,

Romania
Bnescu Claudia1, Pacanu Ionela1, Csp Katalin1, Benedek I.2, Benedek Erzsbet2, Duicu
Carmen3, Butil Todoran Anamaria1
1. Genetics Department University of Medicine and Pharmacy Tg.Mure, Romnia;
2. Hematology Clinic 2 University of Medicine and Pharmacy Tg. Mure, Romnia;
3. Pediatric Clinic University of Medicine and Pharmacy Tg.Mure, Romnia
The cytogenetic analyse is an important part of the protocol of investigation of patients with
hematological malignant diseases.
The karyotypes of 164 patients between ages of 2 and 76 years, 30/164 acute lymphoblastic
leukemia (ALL), 28/164 acute myeloid leukemia (AML), 52/164 chronic myeloid leukemia (CML),
20/164 myelodysplastic syndrome (MDS), and 34/164 chronic lymphocytic leukemia, (CLL), were
analyzed. We carried out the bone marrow and/or peripheral blood culture according to standard meth-
ods.
In our study, in ALL the most frequent chromosomal abnormality was hiperdiploidy and we
found only two cases of Ph+ chromosome. The most frequent clonal karyotype alteration in AML was
hiperdiploidy, detected in 50% of AML cases, while metaphases with structural abnormalities were
found in 25% of cases. We report only two SMD cases with 7q deletion, while 20% of SMD patients
presented aneuploidy. Ph chromosome was detected in 80% of patients with CML. The Ph chromo-
some frequency at the moment of diagnosis in CML was 92%. We didnt report any case with double
Ph+ and we had only one case with i(17q). Clonal cytogenetic abnormalities were detected in 12 pa-
tients with CLL. An abnormal clone carrying t(7q;14q) was detected in one patient with CLL. We did-
n't find deletions at 13q even it is the most common genetic abnormality in CLL. In our study the most
frequently observed chromosome abnormalities in CLL are numerical aberrations, mainly +21, +12
and +X.
Keywords: malignant hematologic disease, chromosomal abnormality
Analize citogenetice n hemopatiile maligne n Tg. Mure, Romnia

Bnescu Claudia1, Pacanu Ionela1, Csp Katalin1, Benedek I.2, Benedek Erzsbet2, Duicu
Carmen3, Butil Todoran Anamaria1
1. Disciplina de Genetic - UMF Tg.Mure, Romnia; 2. Clinica de Hematologie 2 - UMF
Tg.Mure, Romnia; 3. Clinica de Pediatrie - UMF Tg.Mure, Romnia
Analiza citogenetic face parte din protocolul de investigare a pacienilor cu hemopatii maligne.
Au fost investigai citogenetic 164 de pacieni, cu vrsta cuprins ntre 2 i 76 de ani, 30/164 cu leuce-
mie acut limfoblastic (LAL), 28/164 cu leucemie acut mieloid (LAM), 52/164 cu leucemie mie-
loid cronic (LMC), 20/164 cu sindrom mielodisplazic (SMD) i 34/164 cu leucemie limfocitar cro-
nic (LLC). S-au efectuat culturi celulare din mduva osoas hematogen i/sau snge periferic,
conform metodelor standard.
In studiul nostru, cea mai frecvent anomalie cromozomial ntlnit la pacienii cu LAL a fost
hiperdiploidia, doi dintre pacienii cu LAL prezentnd cromozom Ph+. Cea mai frecvent anomalie
cariotipic clonal n LAM a fost hiperdiploidia, evideniat n 50% dintre cazuri, n timp ce anomaliile
structurale au fost detectate doar la 25% dintre pacienii cu LAM. Raportm doar dou cazuri de SMD
cu deleie 7q, n timp ce aneuploidia a fost prezent la 20% dintre pacienii cu SMD.
80% dintre pacienii cu LMC au prezentat cromozom Philadelphia. Frecvena cromozomului Ph
n momentul diagnosticului a fost de 92%. Nu am avut nici un caz cu cromozom Ph suplimentar i doar
un pacient a prezentat i(17q). Anomaliile clonale citogenetice au fost detectate la 12 dintre pacienii cu
LLC. Unul dintre pacienii cu LLC a prezentat translocatie t(7q;14q). Nu am gsit deleii 13q dei este
cea mai frecvent anomalie cromozomial n LLC. Cele mai frecvente anomalii cromozomiale ntlnite
la pacienii cu LLC sunt anomaliile numerice, mai frecvente fiind +21, +12 i +X.
Cuvinte cheie: hemopatii maligne, anomalii cromozomiale
C10. Somatic activating mutations in myeloproliferative neoplasms as

diagnostic and prognostic markers
Trifa Adrian P.1, Popp Radu A.1, Cucuianu Andrei2, Dima Delia2, Petrov Ljubomir2,
Patiu Mariana2, Militaru Mariela S.1
1. Department of Medical Genetics, U.M.F. Iuliu Hatieganu, Cluj-Napoca; 2. Department
of Haematology, Ion Chiricuta Cancer Institute, Cluj-Napoca
Policythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF) are
three typical non-BCR-ABL myeloproliferative neoplasms (MPN). Recent researches indicated that a
single point somatic activating mutation in the JAK2 (Janus kinase 2) gene, namely V617F is a crucial
molecular event in most of PV cases and about half of the ET and PMF cases. Further, it has been
shown that around 5-10% of the ET and PMF cases harbour somatic activating mutations in the c-MPL
(myeloproliferative leukaemia virus oncogene) gene , notably W515L, W515K and S505N. As from
the 2008 World Health Organization, mast cell disease is also a MPN, more than 80% of the affected
patients harbouring a single point somatic mutation in the c-KIT gene, namely D816V. We present the
optimization of molecular studying protocols for all of these mutations (PCR-RFLP and tetra-primer
PCR for JAK2 V617F mutation AS-PCR for c-MPL W515L, W515K and S505N mutations and c-KIT
D816V mutation), by which their investigation became available in Romania, as well. Meanwhile, we
report partial results of the MPNs molecular investigated so far.
Not only these mutations have a diagnostic value, according to the 2008 WHO classification of
the CMDs, but it seems that some biological and evolutive features depend on the presence of these
mutations, so they may have a prognostic value, as well. As new molecular markers are discovered in
haematological disorders, their evaluation must become part of the investigation protocol, in order to
achieve a correct diagnosis and to provide a correct therapeutic management.
Key-words: myeloproliferative neoplasms, activating mutations, molecular tests.
Mutatii somatice activatoare in neoplasmele mieloproliferative ca markeri

de diagnostic si prognostic
Trifa Adrian P.1, Popp Radu A.1, Cucuianu Andrei2, Dima Delia2, Petrov Ljubomir2,
Patiu Mariana2, Militaru Mariela S.1
1. Catedra de Genetica Medicala, U.M.F. Iuliu Hatieganu, Cluj-Napoca; 2. Clinica de
Hematologie, Institutul Oncologic Ion Chiricuta, Cluj-Napoca
Policitemia vera, trombocitemia esentiala si mielofibroza primara reprezinta trei neoplasme
mieloproliferative clasice, negative pentru fuziunea BCR-ABL. Cercetari recente au indicat faptul ca o
singura mutatie punctiforma somatica activatoare la nivelul genei JAK2 (Janus kinase 2) reprezinta un
eveniment molecular esential in majoritatea cazurilor de policitemia vera si aproximativ jumatate din
cazurile de trombocitemie esentiala si mielofibroza primara. Ulterior, a fost descoperit faptul ca
aproximativ 5-10% din cazurile de trombocitemie esentiala si mielofibroza primara se caracterizeaza
prin mutatii punctiforme somatice activatoare la nivelul genei c-MPL (myeloproliferative leukaemia
virus oncogene), in special W515L, W515K si S505N. Conform clasificarii Organizatiei Mondiale a
Sanatatii a neoplasmelor mieloide, publicata in 2008, si mastocitoza sistemica apartine acestui grup de
boli, mai mult de 80% din pacientii afectati de aceasta boala prezinta o mutatie punctiforma activatoare
la nivelul genei c-KIT, si anume D816V. Prezentam optimizarea unor protocoale de genetica
moleculara utilizate pentru studiul tuturor acestor mutatii (PCR-RFLP si tetra-primer PCR pentru
mutatia JAK2 V617F, AS-PCR pentru mutatiile c-MPL W515L, W515K si S505N si pentru mutatia c-
KIT D816V), prin care studiul acestora a devenit disponibil si in Romania. In acelasi timp, prezentam
rezultate partiale privind detectia acestor mutatii la pacientii investigati pana in prezent. Demonstrarea
acestor mutatii in cazurile de neoplasme mieloide a devenit criteriu major de diagnostic, conform
ultimilor algoritmi de diagnostic ai acestor boli, publicati in 2008. De asemenea, se pare ca prezenta
acestor mutatii se coreleaza cu unele particularitati biologice si evolutive ale acestor boli, putand
reprezenta in acelasi timp si factori de prognostic. Pe masura ce progresele geneticii moleculare fac
posibila descoperirea a noi markeri moleculari in procesele maligne hematologice, studiul lor devine
parte obligatorie a planului de investigatii, pentru a asigura un diagnostic si o atitudine terapeutica
corecte.
Cuvinte cheie: neoplasme mieloproliferative, mutatii activatoare, testare moleculara
Hematology 2
C11. The role of cytokines in growth and survival of myeloma cells
Ioni Hortensia, Ioni Ioana
University of Medicine and Pharmacy Victor Babe, Timioara
Multiple myeloma (MM) is a differentiated clonal B-cell tumor comprising proliferating plasma
cells. Myeloma cells are dependent for their survival and growth on cytokines.
Interleukin-6 is the most important cytokine in myeloma; is essential for the proliferation of nor-
mal plasmablastic cells and for the terminal differentiation of plasmoblast to nondividing plasma cells.
In MM, IL-6 is a survival factor and does not induce terminal differentiation.
Insulin like growth factors (IGFs) constitute a family of peptides capable to induce cell prolif-
eration and differentiation. Both IGF-1 and -2 are mitogenic factors secreted by malignant cells. IGF-1
is a growth and survival factor for human myeloma cell lines.
Interleukin-15 induces proliferation and promotes cell survival of T and B cells, natural killer
cells, and neutrophils. Expression of a functional IL-15 receptor was shown in myeloma cell lines.
Blocking IL-15 in myeloma cell lines increases the rate of spontaneous apoptosis.
Interleukin-10 is a potent inducer of immunoglobulin secretion by normal plasma cells. It stimu-
lates proliferation of primary myeloma cells and myeloma cell lines.
Hepatocyte growth factor (HGF) is a cytokine that promotes formation of osteoclasts from hem-
atopoietic precursor cells, attracts osteoclasts to side of bone marrow resorption, and in co-culture with
osteoclasts increases the level of bone resorption .
In myeloma, transforming growth factor beta (TGF-) is produced by bone marrow stroma cells
and myeloma cells. It triggers IL-6 secretion and it causes tumor cell proliferation indirectly, probably
by upregulation of IL-6 secretion.
Tumor necrosis factor- is a potent mediator of inflammation and bone resorption. It modestly
triggers proliferation of myeloma cells.
Rolul citokinelor n creterea i supravieuirea celulelor mielomatoase

Ioni Hortensia, Ioni Ioana
University of Medicine and Pharmacy Victor Babe, Timioara
Mielomul multiplu (MM) este o tumor a celulelor B clonale difereniate, incluznd proliferarea
celulelor plasmocitare. Celulele mielomatoase sunt dependente de citokine, pentru supravieuire i
cretere.
Interleukina 6 a fost considerat cea mai important citokin n MM; este esenial pentru prolif-
erarea celulelor plasmoblastice normale i pentru diferenierea lor terminal de la plasmoblast la
plasmocitul matur. Este un factor de supravieuire important i nu induce diferenierea terminal.
Factorul de cretere insulin-like (IGFs) constituie o familie de peptide care induc proliferarea ce-
lular i diferenierea. IGF1 i 2, sunt factori mitogeni secretai de celulele maligne. IGF1- este un fac-
tor de supravieuire i cretere pentru liniile celulare mielomatoase umane.
Interleukina 15 induce proliferarea i supravieuirea celulelor T i B, celulelor NK i neutrofile-

lor. Expresia funcional a receptorului IL-15 s-a demonstrat n liniile celulare mielomatoase. Blocarea
IL-15 n liniile celulare mielomatoase crete rata apoptozei spontane.
Interleukina 10 este un inductor important al secreiei de imunoglobulin de ctre plasmocitele
normale. Aceasta stimuleaz proliferarea celulelor mielomatoase primare i liniile celulare mieloma-
toase.
Factorul de cretere hepatocitar (HGF) este o citokin care promoveaz formarea osteoclastelor
din celulele hematopoietice precursoare, atrage osteoclastele la locul resorbiei osului medular, iar n
culturile cu osteoclaste crete nivelul resorbiei osoase.
n mielom, factorul transformator al creterii (TGF-) este produs de celulele stromei mduvei
osoase i de celulele mielomatoase. Acesta influeneaz secreia de IL-6 i determin astfel, indirect,
proliferarea celular tumoral probabil prin reglarea secreiei de IL-6.
Factorul de necroz tumoral este un mediator puternic la inflamaiei i resorbiei osoase, acesta
determin o proliferare modest a celulelor mielomatoase.
R15. Pure red cell aplasia in immunosuppressed renal transplant recipients.

Case report and literature review
Patiu Mariana1, Selicean Cristina 1, Filipas Cristina 1, Nastase Violeta1, Cucuianu Andrei2
1. Ion Chiricuta Cancer Institute, Hematology Dept, Cluj Napoca; 2. University of
Medicine and Pharmacy Iuliu Haieganu Cluj Napoca
Anaemia is an important and frequent event after renal transplant. The prevalence of anaemic
syndrome in renal transplant recipients is estimated at 20-40%; distinguishing between different under-
lying causes of anaemia is extremely important for therapy.
The case report presents two patients who received a renal transplant at the Institute for Urology
and Renal Transplant from Cluj-Napoca.
SM, 41 year old woman, with polycystic kidney disease, renal dialysis since 2004, transplant re-
cipient in 2005 from living unrelated donor, immunosuppressive treatment. Sudden onset of anaemia in
august 2008, with haemoglobin 4g/dl, clinically accompanied by an infectious syndrome. Bone marrow
aspirate reveals suggestive changes for an infection with Parvovirus B19. Therapy with immuno-
globulin and erythropoietin, and reduction of immunosuppression were followed by increase of haemo-
globin level up to 11 g/dl.
CI, 38 year old male, hereditary lysozym amyloidosis with renal, splenic and hepatic involve-
ment, diagnosis established at the Fundeni hospital in June 2007, transplant recipient from genetically
related donor, splenectomy in April 2008 for splenic rupture. Haemoglobin level decreases progress-
ively to 4,4 g/dl. Bone marrow aspirate reveals hypoplastic erythroid series and the presence of giant
proerythroblasts suggestive for involvement of Parvovirus B19 in the pathogenesis of the anaemic syn-
drome.
Immunosuppressed patients infected by Parvovirus B 19 develop pure red cell aplasia with giant
proerythroblasts in the bone marrow.
If modern diagnostic tools for parvovirus B 19 infection are lacking, bone marrow aspirate can
yield a highly suggestive picture.
Aplazie pur a seriei eritrocitare la pacieni cu transplant renal i tratament

imunosupresiv. Prezentare de caz i revizuirea datelor din literatur
Paiu Mariana1, Selicean Cristina1, Filipas Cristina1, Nstase Violeta1, Cucuianu Andrei2
1. Institutul Oncologic Ion Chiricu, Departamentul Hematologie, Cluj Napoca; 2. UMF
Iuliu Haieganu Cluj Napoca
Anemia este frecvent ntlnit la pacienii cu transplant renal. Prevalena sindromului anemic la
aceti pacieni este estimat la 20-40%; stabilirea cauzei anemiei este extrem de important pentru
alegerea regimului terapeutic.
Prezentm doi pacieni transplantai renal la Institutul de Urologie i Transplant Renal Cluj-
Napoca.
SM, 41 ani, sex F, cu boal polichistic renal, dializat din 2004, transplantat n 2005 cu
rinichi de la donator viu, genetic nenrudit, face tratament imunosupresor.
n august 2008 se instaleaza brusc un sindrom anemic sever cu hemoglobina 4 g/dl n context
infecios. Aspiratul medular prezint modificari sugestive pentru infecia cu Parvovirus B19. Terapia
cu imunoglobuline, eritropoietin i reducerea imunosupresiei este urmat de creterea nivelului
hemoglobinei la 11 g/dl.
CI, 38 ani, sex M, cu amiloidoz ereditar tip lizozim, cu interesare renal, splenic i hepatic,
diagnostic stabilit la Spitalul Fundeni n iunie 2007, transplantat cu rinichi de la donator genetic
nrudit, splenectomizat n aprilie 2008 pentru ruptur de splin. Nivelul hemoglobinei scade progresiv
la 4,4 g/dl. Aspiratul medular relev hipoplazia seriei eritrocitare cu prezena de proeritroblati gigani,
sugestiv pentru infecia cu Parvovirus B 19.
Pacienii imunosupresai infectai cu Parvovirus B19 dezvolt aplazie pur a seriei roii cu
progigantoblati n maduv.
n absena posibilitilor diagnostice moderne pentru infecia cu Parvovirus B19, aspectul
maduvei osoase este nalt sugestiv.
C16. Utility of CD34 and CD117 markers in management of acute myeloid

leukemia
Bacrea Anca 1, Paiu Mariana 2, Cucuianu Andrei 2, Bacrea Vladimir 1, Dorcioman
Bogdana 3, Oltean Galafteon 1
1. University of Medicine and Pharmacy Tg Mures, 2. Ion Chiricuta Cancer Institute, Cluj-
Napoca, 3. Emergency Clinical Hospital Mures
Analysis panels for acute myeloid leukemia (AML) usually include CD34 and CD117. Blast
cells can be distinguished from maturing myeloid cells by means of the expression of these immaturity
markers and help in establishing myeloid lineage. Some blasts are CD34 and CD117 negative and thus
are difficult to distinguish from more mature cells (CD34 negative monoblasts from mature mono-
cytes). For this reason it is preferable not to distinguish blasts according to CD34 expression.
Opinions in what concerns CD34 value as prognostic factor are various. Some authors consider
that a high expression of CD34 correlates with a low rate of complete remission (CR) and other authors
that CD34 should not be considered a marker of poor prognosis in AML.
The aim of our study was to evaluate the frequency of these two markers expression in our lot
and their prognostic significance as single markers and in combination.
Our lot includes 59 adult patients with newly diagnosed AML at the Hematology Department of
Medical Clinic I in Tg-Mures and at the Hematology Department of Ion Chiricuta Cancer Institute
Cluj-Napoca. The inclusion criterion was: untreated patients with primary or secondary AML at the
time of diagnosis, with complete investigations, between 2006 and 2008.
The frequency of CD34 expression in our lot was 76,3%. CD34 was positive on blast cells
between 20% and 99% with medium of 64% and median of 68%. The frequency of CD117 expression
in our lot was 75%.
Individual expression of the two markers did not influence obtaining CR and l year remission.
We compared survival of patients CD34+ against those CD34-. Although medium of survival of
CD34+ patients was 6 month versus 8 month in CD34- patients, CD34 did not significantly correlate
with overall survival (OS) (p = 0,14). CD34+/CD117- significantly influenced survival, because these
patients had significant lower survival than those CD34+ and CD117+ (p = 0,01).
Our study shows the diagnostic value of the studied markers, but their individual expression
did not influence evolutional parameters. Analysis of CD34 and CD117 association has prognostic
value.
Utilitatea markerilor CD34 i CD117 n managementul leucemiei acute

mieloide
Bacrea Anca 1, Paiu Mariana 2, Cucuianu Andrei 2, Bacrea Vladimir 1, Dorcioman
Bogdana 3, Oltean Galafteon 1
1. UMF Tg Mure, 2. Institutul Oncologic Ion Chiricu Cluj Napoca, 3. Spitalul Clinic
Judeean de Urgen Mure
Panelurile de analiz pentru lecemia acut mieloid (LAM) includ markerii CD34 i CD117,
mieloblatii pot fi difereniai de celulele mieloide n maturare prin expresia acestor markeri de imatur-
itate, respectiv ajut la stabilirea apartenenei la linia mieloid. Unii blati ns, sunt negativi pentru
CD34 i CD117 i sunt greu de difereniat de celulele mai mature (monoblatii CD34 negativi de mo-
nocitele mature). De aceea, chiar dac este tentant, este preferabil ca selecia blatilor s nu se fac n
funcie de CD34. Prerile n ceea ce privete valoarea prognostic a lui CD 34 sunt mprite. Unii au-
tori consider c expresia nalt a lui CD34 se coreleaz cu o rat mai mic a remisiei complete (RC),
iar alii c nu are vreo semnificaie prognostic.
Scopul studiului nostru a fost s evalum frecvena expresiei celor doi markeri pe lotul studiat,
semnificaia lor prognostic, att ca expresie individual, ct i n asociere.
Lotul analizat include 59 pacieni diagnosticai n Clinica Medical I a Spitalului Clinic Judeean
de Urgen Tg Mure i n Clinica de Hematologie a Institutului Oncologic Ion Chiricu Cluj
Napoca. Criteriul de includere n studiu a fost - pacieni aduli cu LAM primare i secundare, complet
investigai, diagnosticai n perioada 2006-2008.
Frecvena expresiei CD34 pe lotul studiat a fost de 76,3%. Markerul a fost pozitiv la nivelul pop-
ulaiei blastice ntre 20% i 99%, cu o medie a expresiei de 64 % i o median de 68 %. Frecvena ex-
presiei CD117 pe lotul studiat a fost de 75%.
Expresia individual a celor doi markeri nu a influenat obinerea RC, nici meninerea remisiei la
1 an. Am comparat supravieuirea pacienilor cu CD34+, fa de cei CD34-. Dei media timpului de
supravieuire a pacienilor cu CD34+ a fost 6 luni, fa de 8 de luni la cei CD34-, CD34 nu s-a corelat
semnificativ cu supravieuirea global (SG) (p = 0,14). Asocierea CD34+/CD117- a influenat semni-
ficativ statistic supravieuirea, deoarece aceti pacieni au trit semnificativ mai puin dect cei CD34+
i CD117+ (p = 0,01).
Studiul nostru indic valoarea diagnostic a celor doi markeri, fr ca expresia lor individual s
influeneze parametrii evolutivi. Analiza asocierii CD34 i CD117 are valoare prognostic.
Genetics
C19. Role of genetic analysis and research for rare diseases diagnosis
Puiu Maria, Stoian Monica
Dept. of Medical Genetics, Victor Babe University of Medicine and Pharmacy Timioara
A disease is considered rare if it affects less than 5/10000 of people. Most of rare diseases are ge-
netic disorders, resulting from inherited or newly arising mutations in genes involved in the develop-
ment and function of different organ systems.
The development of genetic investigations techniques from conventional cytogenetic analysis, to
cytogenetic-molecular techniques and molecular investigations of the gene sequence and gene expres-
sion in different tissues, made possible the diagnosis of many genetic disorders and identified the un-
derlying causes. The etiologic identification allows an early, accurate diagnosis and an adequate genet-
ic counseling for the patients, as a means reducing of risk of recurrence in the family.
As specific disease syndromes are recognized and the responsible genes identified, mutations in
individual families can be identified. Correlation of mutation sites with clinical information will help
determine how specific gene segments encode important functional protein domains.
Families with rare disorders of known or suspected genetic basis will be enrolled. Genetic link-
age studies are an important aspect of the research regarding rare diseases and will include all available
family members, while gene sequence analysis will be performed on affected individuals. Subjects
considered by the investigators to be appropriate for linkage studies will be invited to participate by the
medical geneticians.
Animal model studies have contributed to the explosion of new knowledge. In recent years, mo-
lecular genetics has given important insights regarding pathogenesis in many disorders we can expect
more advances as geneticists continue. More effective remedies are being under research, including
possible treatment for the gene defect itself. Experts see many more in the future, as research in mo-
lecular genetics opens some of the "black boxes" of biology.
Keywords: rare diseases, genetic analysis, genetic research
Rolul investigaiilor genetice i al cercetrii n diagnosticul bolilor rare

Puiu Maria, Stoian Monica
Dept. de Genetic Medical, UMF Victor Babe Timioara
O boal este considerat rar dac afecteaz mai puin de 5/10000 de indivizi. Majoritatea bolilor
rare sunt afeciuni genetice, determinate de mutaii transmise din generaie n generaie sau aprute de
novo, n gene implicate n dezvoltarea sau funcionalitatea diferitelor sisteme i organe.
Dezvoltarea tehnicilor de investigare a bolilor genetice, de la tehnicile de citogenetic con-
venional, la cele de citogenetic molecular, i culminnd cu investigaiile moleculare la nivel de
secven genic i expresie genic n diferite esuturi, au permis stabilirea diagnosticului multor afeci-
uni genetice i identificarea mecanismelor cauzatoare. Precizarea etiologiei permite un diagnostic ex-
act, precoce i un sfat genetic adecvat, ca mijloc de reducere a riscului de recuren a bolii n familie.
Pe msur ce sindroame specifice sunt recunoscute i genele cauzatoare sunt precizate, este pos-
ibil identificarea mutaiilor aprute n cadrul familiilor individuale. Corelaia dintre poziia mutaiei n
cadrul secvenei genice i aspectul clinic al bolii va permite identificarea modului de codare al unor
segmente genice n diferite domenii funcionale ale proteinelor.
Familiile care au membri afectai trebuie luate n studiu. Analizele de linkaj genic reprezint un
aspect important al cercetrii privind bolile rare i trebuie s includ toi membrii disponibili, dar anal-
iza secvenierii genice va fi efectuat doar la indivizii afectai. Indivizii luai n observaie pentru anal-
iza linkajului genic vor fi contactai de medicul genetician.
Modelele de studiu pe animal au contribuit la explozia descoperirilor n domeniul geneticii mo-
leculare. n ultimii ani, genetica molecular a fcut posibil descifrarea mecanismelor patogenice n
multe boli i se ateapt descoperiri mai avansate pe masur ce cercetrile avanseaz. Cercetarea
vizeaz remedii mai eficiente pentru aceste boli, majoritatea fr tratamente specifice, incluznd pos-
ibile terapii genice.
Cercettorii prevd mai multe dezvluiri de aceast manier pe viitor, deoarece cercetarea n ge-
netica molecular deschide tot mai multe dintre cutiile negre ale biologiei.
Cuvinte cheie: boli rare, investigaii genetice, cercetare genetic
C20. Correlations of clinical, genetic and epigenetic in Prader-Willi

syndrome: model of multidisciplinary approach for the management of rare
diseases in Romania
Puiu Maria, Stoian M., Belengeanu V., Cucu N.2, Anton G.3, Badiu C.4, Dan D.5
1. Dept. of Medical Genetics, Victor Babe University of Medicine and Pharmacy
Timioara; 2. Dept. of Epigenetics, Faculty of Biology Bucharest; 3. National Institute of
Virusology Bucharest; 4. National Institute of Endocrinology Bucharest; 5. Romanian
Association Prader-Willi, Romanian National Aliance of Rare Diseases
Aim of the study: The aim of our study is the integration of a multidisciplinary approach for
Prader-Willi syndrome, a genomic diseases caused by absent expression of the paternally active genes
on chromosome 15. Most patients with Prader-Willi syndrome are missing the genetic material on part
of the paternal chromosome. The remaining patients frequently have two copies of the maternal chro-
mosome 15.
Materials and Methods: The study envisages the cytogenetic and molecular genetics ap-
proaches in the syndrome diagnosis, establishing a European research network partnership. This re-
search will allow: 1. establishment of a strategy in definition for genotypes PWS; 2. correct identifica-
tion of the genetic defect; 3. detection of the variation in gene expression/gene subsequention and their
regulation pathway mechanism; 4. the involvement of epigenetic factors that modulate (enhancing/de-
creasing) the severity of phenotypic aspects into the diagnosis protocols. The team involved in the
study is multidisciplinary, comprising medical specialists, but also with regard to the habilitation as-
pects. In order to reach successful outcomes, cooperation between family and team members, during
the phases of diagnosis and treatment must exist.
Results: PSW is associated to high mortality and morbidity, thus, this study wishes to set the
ground for guidelines for early diagnosis and treatment, in order to improve the medical and social
standard for affected patients with PWS. Our preliminary data show weight loss, improvements in:
family's educational management, coordination of movements, self-management and a reduction of
anxiety.
Conclusions: The Romanian research should be more active in the rare disease area, that's why
we propose an epigenetic new European approach realized by prestigious teams. Through this new type
of partnership between universities, research institutes, hospitals, nongovernmental associations of af-
fected patients we try to redefine connections between fundamental research and the medical practice,
developing a multidisciplinary investigation model for rare disease in Romania.
Keywords: PWS (Prader-Willi Syndrome), epigenetics, rare diseases
Corelaii clinice-genetice-epigenetice n sindromul Prader-Willi: Model de

abordare interdisciplinar a bolilor rare n Romnia
Puiu Maria, Stoian M., Belengeanu V., Cucu N.2, Anton G.3, Badiu C.4, Dan D.5
1. Dept. de Genetic Medical, UMF Victor Babe Timioara; 2. Dept. de Epigenetic
Facultatea de Biologie Bucureti; 3. Institutul Naional de Virusologie Bucureti; 4. Institutul
Naional de Endocrinologie Bucureti; 5. Asociaia Prader-Willi, Romnia, Aliana Naional
a Bolilor Rare Romnia
Scop: Studiul propune o abordare multidisciplinar a sindromul Prader-Willi (PWS), afeciune
genetic, determinat de absena genelor cu expresie patern de pe cromozomul 15. Majoritatea pa-
cienilor cu PWS datoreaz sindromul absenei unei regiuni de pe cromozomul 15. Restul pacienilor
prezint dou cpii ale cromozomului 15 matern.
Material si metode: Studiul propune investigarea citogentic i molecular pentru diagnosticul
sindromului i crearea unui parteneriat cu reeaua european de cercetare. Studiul va permite: 1. stabi-
lirea unei strategii pentru definirea genotipurilor PWS; 2. identificarea exact a defectului genetic; 3.
descifrarea variaiei expresiei genice/secvenei genice i cile reglatoare ale mecanismelor patogenice;
4. implicarea factorilor epigenetici care moduleaz severitatea tabloului clinic. Echipa implicat n
aceast cercetare este multidisciplinar i multicentric, iar pentru rezultate optime, pe parcursul eta-
pelor de diagnostic i tratament, se asigur o bun colaborare ntre echip i membrii familiei.
Rezultate: PWS este asociat cu mortalitate i morbiditate crescute, astfel acest studiu i
propune s stabileasc bazele pentru un diagnostic i tratament precoce, pentru a mbunti standardul
medical i social al pacientilor cu PWS. Datele preliminare relev o scdere n greutate a pacienilor
din studiu, mbuntirea managementului educaional al familiei, coordonarea micrilor, auto-control

i reducerea anxietii.
Concluzii: Cercetarea romneasc ar trebui sa fie mai vizibil n sfera bolilor rare. n acest sens,
propunem o abordare epigenetic nou a bolii, inserat tendinelor europene de cercetare, realizat de
echipe prestigioase. Printr-un model nou de parteneriat ntre universiti, institute de cercetare, spitale,
asociaii nonguvernamentale, vom ncerca s redefinim legatura dintre cercetarea fundamental i prac-
tica medical, punnd bazele unui model de investigare multidisciplinar pentru bolile rare din
Romnia.
Cuvinte cheie: sindrom Prader-Willi (PWS), epigenetic, boli rare
C21. Evaluations of chromosomal abnormalities diagnosed prenataly in

Cluj Napoca
Militaru Mariela, Popp R.A., Trifa A., Militaru M., Stamatian F.
1. Dept. of Medical Genetics, Iuliu Haieganu University of Medicine and Pharmacy Cluj-
Napoca; 2. Clinic of Paediatrics II, Iuliu Haieganu University of Medicine and Pharmacy
Cluj-Napoca; 3. Clinic of Ginecology I, Iuliu Haieganu University of Medicine and
Pharmacy Cluj-Napoca
Prenatal diagnosis for chromosomal disorders is performed routinely in populations since most
of these disorders have severe consequences such as major malformations and mental retardation.
Since advanced technologies in rapid diagnostic tests have been developed to detect common trisomies
prenataly it is essential that each laboratory should evaluate their own prenatal diagnosis profile. In this
study we aimed to investigate the type and proportion of chromosomal abnormalities detected in cyto-
genetic studies prenataly and referral indications in 684 pregnant cases in Cluj-Napoca, Romania
between the period of 2002-2007. The overal chromosomal abnormality rate was found to be 49/684
(7,76%). The cytogenetic analysis with GTG banding of amniotic fluid cells revelead: trisomy 21(12
cases), trisomy 18 (7 cases), monosomy X (6 cases), trisomy 16 (1 case), trisomy 8 (1 case), trisomy 15
(1 case), robertsonian translocations (2 cases), Klinefelter syndrome (3 cases), autosomal deletions (3
cases), autosomal monosomy (2 cases), poliploidy (3 cases), chromosome marker (6 cases), trisomy X
(1 case), Fra 5q31 (1 case). Cytogenetic prenatal diagnosis is a method for prevention chromosomal
disorders, especially for the aneuploidy.
Keyword: amniotic fluid, G-banding, chromosomal abnormalities
Studiul cromosomilor fetali din lichidul amniotic n centrul universitar

Cluj-Napoca
Militaru Mariela, Popp R.A., Trifa A., Militaru M., Stamatian F.
1. Catedra de Genetic Medical; 2. Catedra Pediatrie II; 3. Catedra Ginecologie I,
UMF Iuliu Haieganu Cluj-Napoca
Diagnosticul prenatal pentru bolile cromosomiale se realizeaz frecvent la nivel populaional de
cnd majoritatea acestor boli au avut consecine severe cum ar fi malformaiile majore i retardul
mental. Odat cu dezvoltarea tehnicilor rapide de diagnostic prenatal pentru majoritatea trisomiilor este
esenial ca fiecare laborator s-i evalueze propriul profil n acest domeniu. Studiul de fa este unul
retrospectiv, extins pe perioada 2002- 2007 i a cuprins 684 gravide crora li s-a efectuat
amniocenteza. Morfologia cromosomilor din lichidul amniotic a fost studiat folosind bandarea G. n
urma analizei citogenetice au fost decelate 49 de anomalii cromosomiale, ceea ce reprezint 7,76 % din
totalul cazurilor studiate.Tipurile de modificri citogenetice au fost urmatoarele: trisomie 21 (12
cazuri), trisomie 18 (7 cazuri), monosomie X (6 cazuri), trisomie16 (1 caz), trisomie 8 (1caz), trisomie
15 (1caz), translocaii robertsoniene (2 cazuri), sindrom Klinefelter (3 cazuri), deleii autosomale (3
cazuri), monosomii autosomale (2 cazuri), poliploidii (3 cazuri), cromosom marker (5 cazuri),
cromosom 15 bisatelitat (1 caz), trisomie X (1 caz), Fra5q31(1 caz). Se poate aprecia c diagnosticul
citogenetic prenatal este o metod eficace n profilaxia bolilor cromosomiale, n special a
aneuploidiilor.
Cuvinte cheie: lichid amniotic, benzi G, anomalii cromosomiale
C22. The importance of chromosomal analysis in diagnosis of

plurimalformative syndromes
Gorduza Eusebiu Vlad1, Grmescu Mihaela1, Rusu Cristina1, Volociuc Mihail2, Bujoran
Cornel2, Ivanov Iuliu3, Braha Elena1, Butnariu Lcrmioara1, Pnzariu Monica1, Caba
Lavinia1, Popescu Roxana1, Stoica Ortansa1, Covic Mircea1
1. Dept. of Medical Genetics, Laboratory of Cytogenetics, Gr. T. Popa University of
Medicine and Pharmacy Iai, 2. Sf. Maria Clinical Paediatric Hospital Iai; 3. Laboratory
of Immunology and Genetics, Sf. Spiridon Emergency Clinical Hospital Iai
Etiological diagnosis of plurimalformative syndromes imposes the chromosomal analysis.
Between 2001-2008, in Cytogenetic Laboratory of UMF Iai, we realised 646 karyotypes in
plurimalformative syndromes (38,29%). In cranio-facial dysmorphism (95 cases 14,70%) we found
17 abnormal cases (17,84%): 6 deletions, 4 chromosomes with unknown supplimentary material (add)
2 insertions, 2 mosaicism, 1 inversion, 1 trisomy 21 and 1 tetrasomy XXYY. In clinical indefinite
plurimalformative syndromes (82 cases 12,69%) we found 25 abnormal cases (30,48%): 7 deletions,
5 add, 4 trisomies 13, 3 trisomies 18, 3 partial trisomies, 2 trisomies 21 and 1 triploidy. At patients with
recognizable plurimalformative syndromes (72,61%) we found the following: In Down syndrome,
from 409 cases, 400 were confirmed (350 homogenous 21 trisomies (87,5%), 27 mosaicism trisomy 21
(6,75%), 17 trisomies 21 by Robertsonian translocations (4,25%) and 6 cases with other form of 21
trisomy (1,5%)). In other plurimalformative syndromes we identified the following: Edwards syndrome
11 cases (6 trisomies 18 and 1 add(9)), Patau syndrome 6 cases (3 trisomies 13) velocardiofacial
syndrome - 5 cases (all normales), Prader-Willi syndrome 5 cases (1 microscopical 15q deletion and
1 submicroscopical deletion), Wolf-Hirschhorn syndrome 6 cases (3 microscopical 4p deletion and 2
submicroscopical deletion), Williams syndrome 9 cases (1 microscopical 7q deletion and 1
submicroscopical deletion), X fragil syndrome 14 cases (2 confirmed) and cri du chat syndrome
4 cases (2 microscopical 5p deletions). Our study indicates the importance of classical chromosomal
analysis in plurimalformative syndrome, in association with molecular cytogenetic techniques.
Keywords: chromosomal analysis, plurimalformative syndromes, chromosomal abnormalities
Importana analizei cromosomice n diagnosticul sindroamelor

plurimalformative
Gorduza Eusebiu Vlad1, Grmescu Mihaela1, Rusu Cristina1, Volociuc Mihail2, Bujoran
Cornel2, Ivanov Iuliu3, Braha Elena1, Butnariu Lcrmioara1, Pnzariu Monica1, Caba
Lavinia1, Popescu Roxana1, Stoica Ortansa1, Covic Mircea1
1. Disciplina de Genetic Medical, Laboratorul de Citogenetic, UMF Gr. T. Popa Iai;
2. Spitalul Clinic de Pediatrie Sf. Maria Iai; 3. Laboratorul de Imunologie i Genetic,
Spitalul Clinic de Urgene Sf. Spiridon Iai
Diagnosticul etiologic al sindroamelor plurimalformative necesit analiz cromosomic. n
perioada 2001-2008, n Laboratorul de Citogenetic al UMF Iai au fost realizate 646 de cariotipuri n
sindroame plurimalformative (38,29%). n dismorfiile cranio-faciale (95 cazuri 14,70%) am
evideniat 17 cazuri anormale (17,84%): 6 deleii, 4 cromosomi cu material suplimentar de origine
necunoscut (add) 2 inserii, 2 mozaicuri, 1 inversie, 1 trisomie 21 i o tetrasomie XXYY. n
sindroamele plurimalformative nedefinite clinic (82 de cazuri 12,69%) am gsit 25 de cazuri
anormale (30,48%): 7 deleii, 5 add, 4 trisomii 13, 3 trisomii 18, 3 trisomii pariale, 2 trisomii 21 i o
triploidie. La pacienii cu sindroame plurimalformative recunoscute clinic (72,61%) am gsit
urmtoarele date: n sindromul Down, din 409 cazuri, 400 au fost confirmate (350 de trisomii 21
omogene (87,5%), 27 de trisomii 21 n mozaic (6,75%), 17 trisomii 21 prin translocaii Robertsoniene
(4,25%) i 6 trisomii 21 de alt tip (1,5%)); n alte sindroame plurimalformative am identificat
urmatoarele: sindromul Edwards 11 cazuri (6 trisomii 18 i un add (9)), sindromul Patau 6 cazuri (3
trisomii 13), sindromul velocardiofacial - 5 cazuri (toate normale), sindromul Prader-Willi 5 cazuri (1
deleie 15q microscopic i 1 deleie submicroscopic), sindromul Wolf-Hirschhorn 6 cazuri (3
deleii 4p microscopice, 2 deleii submicroscopice), sindromul Williams 9 cazuri (1 deleie 7q
microscopic i 1 deleie submicroscopic), sindromul X fragil 14 cazuri (2 confirmate) i sindromul
cri du chat 4 cazuri (2 deleii 5p microscopice). Studiul nostru atest importana analizei
cromosomice clasice n sindroamele plurimalformative, eventul completat de tehnici de citogenetic
molecular.
Cuvinte cheie: analiz cromosomic, sindroame plurimalformative, anomalii cromosomice
C23. Genetic testing in hereditary haemochromatosis

Popp R.A., Trifa A.P., Crisan Tania, Farcas M., Militaru Mariela
Dept. of Medical Genetics, Iuliu Haieganu University of Medicine and Pharmacy Cluj-
Napoca
Hereditary haemochromatosis, one of the most frequent genetic diseases is characterized by a
variable iron overload, leading finally to multisystemic damages. Its incidence is variable, reaching
maximum levels in North European populations, where around 1 in 200 individuals is affected. More
than 80% of the cases are associated with mutations in the HFE gene, the so-called type I, or classical
hereditary haemochromatosis, while the remaining of less than 20% are caused by mutations in gene
encoding other different proteins involved in irons metabolism, the so-called type II, III and IV hered-
itary haemochromatosis. In case of biochemical parameters suggestive for an iron overload, genetic
testing represents a valuable tool for a correct diagnosis and treatment. Despite little is known to date
in our country about the frequencies of the mutations causing iron overload, the development of genet-
ics makes possible that genetic testing become available and meanwhile part of the diagnostic al-
gorithms in Romania, as well. Thus, we would like to highlight the importance of the molecular invest-
igations as part of the correct investigation protocol, available molecular tests, as well as some data re-
garding the distribution of some haemochromatosis-causing mutations in the Romanian population.
Keywords: hereditary haemochromatosis, mutations, molecular diagnosis.
Testarea genetic n hemocromatoza ereditar

Popp R.A., Trifa A.P., Crisan Tania, Farcas M., Militaru Mariela
Catedra de Genetic Medical, UMF Iuliu Haieganu Cluj-Napoca
Hemocromatoza ereditar este una din cele mai frecvente boli genetice, cu afectare multisistem-
ic prin suprancrcarea organismului cu fier, cu o inciden variabil ce poate ajunge la 1 / 200 de in-
divizi n populaiile nord-europene. Cea mai mare parte a cazurilor de hemocromatoza sunt de tip I,
mutaiile genei HFE reprezentnd aproximativ 80% din totalitatea mutaiilor ce determin hemocroma-
toza ereditar; n restul cazurilor, tulburrile metabolismului fierului sunt determinate de mutaii ale
altor gene, determinnd hemocromatoza de tip II, III sau IV. n prezena unor modificri ale paramet-
rilor bioumorali care denot o suprancrcare cu fier, testarea genetic devine un factor esenial pentru
diagnostic i tratament. Dei nc n prezent frecvena mutaiilor la nivelul genelor implicate n etiolo-
gia hemocromatozei ereditare este puin cunoscut n Romnia, n ultimii ani dezvoltarea geneticii
creaz premizele pentru ca testarea genetic s devin accesibil i s se constituie n parte integrant a
algoritmului de diagnostic i n ara noastr. n acest context, dorim s subliniem importana pe care o
pot avea testele moleculare n stabilirea diagnosticului corect, testele disponibile precum i unele date
viznd frecvena unor mutaii n populaia din Romnia.
Cuvinte cheie: hemocromatoza ereditar, mutaii, diagnostic molecular.
C24. Possibilities and challenges in the molecular diagnosis of monogenic

diseases: lysosomal storage disorders
Csp Katalin1, Drugan Cristina2, Pacanu Ionela1, Bnescu Claudia1, Butil Todoran
Anamaria1
1. University of Medicine and Pharmacy Tg. Mure Department of Genetics, 2. University of
Medicine and Pharmacy Cluj-Napoca Department of Biochemistry
Despite the monogenic etiology, in inherited metabolic diseases, the final diagnosis is generally
made by classic biochemical methods. This is the case in lysosomal storage disorders too, where the
suspected clinical diagnosis is confirmed by enzyme assay carried out by fluorimetry or mass specto-
metry, and DNA analysis is not mandatory for the diagnosis or inititation of the treatment.
Like in most enzymopathies, the inheritance is recessive (autosomal, except for the X-linked
Fabry disease and MPS II). Patients homozygotic for the mutant gene are in fact frequently compound
heterozygotes. Genetic heterogeneity is characterteristic, with tens or hundreds of iso- or heteroalleles
of the same gene caused by various mutation mechanimsms or at different nucleotide levels. New
mutations are continuously reported like the c.874G>A (p.A292T) missene mutation of the GLA gene
identified in a Romanian family with Fabry disease (Spnu et al., 2007). Though the targeted identific-
ation of common mutations of the GBA gene (N370S, L444P, R463C, 84GG, recNciI, recTL) is car-
ried out by PCR-based techniques in the national diagnostic center, often sequencing is required done
in collaboration with foreign laboratories from the shipped blood or DNA samples.
The identification of the genotype is the basis of family screening, carrier testing and prenatal
diagnosis. The genotype-phenotype correlation remains inconclusive in most of the cases, though
sometimes it can be used as a prognostic marker (e.g. the lack of neuronpathy in Gaucher patients
homo-or heterozygous for the N370S allele).
In conclusion, the mutation analysis can contribute with valuable information to the successful
management of the affected families, though it must be interpreted carfeully.
Posibilitile i dificultile diagnosticului molecular al afeciunilor

monogenice: bolile de tezaurizare lizosomal
Csp Katalin1, Drugan Cristina2, Pacanu Ionela1, Bnescu Claudia1, Butil Todoran
Anamaria1
1. Universitatea de Medicin i Farmacie Tg. Mure Disciplina de Genetic,
2. Universitatea de Medicin i Farmacie Cluj-Napoca Catedra de Biochimie
n ciuda etiologiei monogenice, n bolile metabolice ereditare diagnosticul final se stabilete n
general prin metode biochimice clasice. Astfel, n cazul bolilor de tezaurizare lizosomal unde diagnos-
ticul clinic suspectat se confirm prin determinarea enzimatic fluorimetric sau prin spectrometrie de
mas, analiza la nivel de ADN nu este obligatorie pentru diagnostic respectiv iniierea tratamentului.
Ca n majoritatea enzimopatiilor, mecanismul de transmitere este autozomal recesiv (cu excepia
bolilor Fabry i MPZ II legate de X). Frecvent pacienii considerai homozigoi recesivi sunt de fapt he-
terozigoi compui. Heterogenitatea genetic este caracteristic, cu zeci sau chiar sute de izo- i hete-
roalele ale genei respective cauzate de mutaii prin mecanisme diferite sau la alt nivel nucleotidic. n
permanen se raporteaz mutaii noi, ca de exemplu mutaia cu sens greit c.874G>A (p.A292T) a ge-
nei GLA identificat la o familie cu boal Fabry din Romnia (Spnu et al., 2007). Dei identificarea
intit a mutaiilor frecvente ale genei GBA (N370S, L444P, R463C, 84GG, recNciI, recTL) se reali-
zeaz n centrul naional de diagnostic prin metode bazate pe PCR, frecvent este necesar secvenierea
n colaborare cu laboratoare din strintate din probele de snge sau AND trimise.
Elucidarea genotipului st la baza screening-ului n familie, a identificrii heterozigoilor i dia-
gnosticului prenatal. Corelaia genotip-fenotip rmne neconcludent n majoritatea cazurilor, dar
uneori poate fi folosit ca marker prognostic (de exemplu, lipsa neuronopatiei la pacienii Gaucher
homo- sau heterozigoi pentru alela N370S).
n concluzie, analiza mutaiilor contribuie cu informaii valoroase la managementul eficace al fa-
miliilor afectate, dei rezultatele trebuie interpretate cu atenie.
C25. Laboratory diagnosis of lysosomal storage diseases

Drugan Cristina1, Grigorescu-Sido Paula2
1. Dept. of Medical Biochemistry, Iuliu Haieganu University of Medicine and Pharmacy
Cluj-Napoca; 2. Clinic of Paediatrics I, Iuliu Haieganu University of Medicine and
Pharmacy Cluj-Napoca
Lysosomal storage diseases, caused by the hereditary deficiency of lysosomal proteins, mostly
enzymes involved in the intracellular degradation of various substrates, are characterised by an
important prevalence (1/5000 - 1/7000), when considered globally. Current biochemical diagnosis
methods are based on the specific assays of various lysosomal enzymes, by fluorimetric or
spectrophotometric methods. Biochemical diagnosis is followed by the identification of specific
mutations for the most frequent lysosomal storage disorders. Our study aimed to identify the most
prevalent lysosomal enzyme deficiencies in Romanian patients, based on biochemical and molecular
assays specifically adapted to the clinical picture. Mutation analysis in Gaucher disease patients
allowed the identification of genotype-phenotype correlations, in agreement with literature data, but
also highlighting specific findings in our patients. Serum chitotriosidase activity was analysed as a
marker of clinical evolution in Gaucher disease patients, in the context of therapeutic monitoring. This
study highlights the importance of laboratory diagnosis in lysosomal storage diseases, as a key-step in
the diagnosis algorithm and underlines the significance of molecular diagnosis and of continuous
monitoring of biochemical markers in these highly heterogeneous disorders.
Diagnosticul de laborator n bolile lizozomale

Drugan Cristina1, Grigorescu-Sido Paula2
1. Catedra de Biochimie Medical, UMF Iuliu Haieganu Cluj-Napoca; 2. Clinica
Pediatrie I, UMF Iuliu Haieganu Cluj-Napoca
Bolile lizozomale, cauzate de deficitul ereditar al unor proteine lizozomale, n majoritatea
cazurilor enzime implicate n catabolismul intracelular al diferitelor substrae, se caracterizeaz printr-o
prevalen destul de ridicat (1/5000 - 1/7000), atunci cnd sunt considerate n ansamblul lor. Metodele
actuale de diagnostic biochimic se bazeaz pe msurarea activitii diferitelor enzime lizozomale, pe
baza unor determinri fluorimetrice sau spectrofotometrice. Determinrile biochimice sunt completate
cu identificarea mutaiilor caracteristice pentru cele mai frecvente dintre bolile lizozomale. n
laboratorul nostru ne-am propus identificarea celor mai frecvente enzimopatii lizozomale la pacienii
din ara noastr, pe baza unor metode biochimice i moleculare, printr-un bilan enzimatic adaptat
tabloului clinic. Analiza mutaiilor frecvente la pacienii cu boala Gaucher a permis conturarea unor
corelaii ntre genotip i fenotip, n concordan cu datele din literatur, dar i evidenierea
particularitilor specifice pentru pacienii romni. Activitatea chitotriozidazei serice, ca marker al
evoluiei clinice n boala Gaucher, a fost analizat n contextul monitorizrii tratamentului de
substituie enzimatic. Acest studiu demonstreaz importana diagnosticului de laborator n bolile
lizozomale, ca etap specific n algoritmul diagnostic i evideniaz semnificaia diagnosticului
molecular i a monitorizrii markerilor biochimici n aceste afeciuni, caracterizate printr-o mare
heterogenitate clinic.
C26. Molecular genetic alterations and their predictive values in superficial

bladder cancer
Babayan A.Y.1,2,3, Bashkatov S.V.4, Karyakin O.B.4, Teplov A.A.5, Zaletaev D.V.1,3,
Nemtsova M.V.1,3
1. Sechenov Moscow Medical Academy, Moscow, Russian Federation; 2. Russian State
Medical University, Moscow, Russian Federation; 3. Medical Genetic Research Centre,
Moscow, Russian Federation; 4. Medical Radiology Research Centre, Obninsk, Russian
Federation; 5. Moscow Herzen Oncological Research Institute, Moscow, Russian Federation
Conventional histopathologic and morphologic factors are widely used to predict poor prognosis
in patients with superficial bladder cancer (BC) underwent transurethral resection. But this system is
not able accurately predict the behavior of the most bladder tumors and need additional factors.
Our purpose was to establish associations between some genetic alterations in respect to unfa-
vorable clinical phenotype (recurrence rate, invasion, high grade) and to determine the prognostic sig-
nificance of these genetic alterations.
We have studied 108 matched samples (blood and tumor tissue) from patients with superficial
BC, of which 12 patients demonstrated recurrence within one year, and 10 samples from patients with
invasive BC. The panel included loss of heterozygosity at 3p14, 9p21, 9q34, p53 locus, activating
mutation in 7 exon FGFR3 and RASSF1A, p16, p14, RARb, CDH1 promoter hypermethylation. Meth-
ods: microsatellite analysis, SSCP and direct sequencing and methyl-sensitive PCR. Statistical analysis
included comparison of the patients clinical groups by Fishers exact test, calculation of odds ratios
and corresponding 95% confidence intervals.
Results: 9p21-locus deletions are significantly more frequent in primary tumors with high recur-
rence rate (within one year) (p=0.049, OR=8.70). FGFR3 mutations are associated with Ta stage
(p=0.0042, OR=5.00). 3p14 locus deletions (=0.042, OR=5.71), RARb (p=0.016, OR=3.91) and p16
(p=0.055, OR=4.17) promoter hypermethylation are associated with high grade tumors. P53 locus dele-
tions (p=0.006, OR=8.10) and p16 hypermethylation (p=0.05, OR=4.09) are significantly more fre-
quent in invasive bladder tumors than in superficial tumors.
Conclusion: Revealed genetic alterations could be used as additional prognostic markers to pre-
dict tumors behavior more accurately.
C27. Sex chromosome abnormalities the experience of the Cytogenetic

Laboratory in Tg. Mures
Pacanu Ionela1,2, Bnescu Claudia1, Csep Katalin1, Butil Todoran Anamaria1, Lazslo
Anamaria2, Gliga Camelia2
1. Genetics Department, University of Medicine and Pharmacy Tg Mure, 2. Endocrinology
Clinic Tg Mure
Sex chromosomes aneuploidy and structural variants of these human chromosomes are found
more frequently in the population than for autosomes, with the exception of trisomy 21. Both the nu-
merical and structural abnormalities may occur in all cells of the body (constitutional abnormality) or
may be present in only certain cells or tissues (mosaic). We analysed all the chromosomal
abnormalities involving sex chromosomes found between 2005-2009 in Cytogenetic Laboratory of
UMF Tg Mures. During this period, in our laboratory, 357 karyotypes were performed. We have used
the standard G banding method, on lymphocytes from peripheral blood. Structural or numerical sex
chromosomes abnormalities were found in 23 cases (6.44%) of all cytogenetic results. The most fre-
quent result was monosomy involving X chromosome (5 cases). The incidence of structural aberration
of the sex chromosomes in our study was 26.08 %. A constitutional abnormality were present in
78.27%, in the rest of 21.73% a mosaic was discovered. Among these results, we found some very rare
cases, with only a few similar results described in the literature, such as: 49,XXXXY; a mosaic
45,X/47,XYY or an inherited translocation involving X chromosome and an autosome. In female the
most frequent clinical referral was primary amenorrhea or short stature and in man the typical clinical
phenotype was infertility or hypogonadism.
Anomalii structurale i numerice ale heterozomilor experiena

Laboratorului de Citogenetic Tg Mure
Pacanu Ionela1,2, Bnescu Claudia1, Csep Katalin1, Butil Todoran Anamaria1, Lazslo
Anamaria2, Gliga Camelia2
1. Disciplina de Genetic, UMF Tg Mure, 2. Clinica de Endocrinologie Tg Mure
Anomaliile structurale i numerice ale heterozomilor sunt mult mai frecvente n populaie n
comparaie cu cele care afecteaz autozomii, cu singura excepie a trisomiei 21. Att aneuploidiile ct
i anomaliile structurale cromozomiale pot fi prezente n toate celulele organismului (constituionale
sau omogene) sau n mozaic (evideniabile numai n anumite celule). Am luat n studiu toate modi-
ficrile cromozomiale ce afecteaz heterozomii din cazuistica Laboratorului de Citogenetic din Tg
Mure, n perioada 2005-2009. n aceast perioad s-au efectuat 357 cariotipuri, folosind tehnica
clasic de bandare G, din limfocitele periferice. Anomalii structurale sau numerice afectnd cromo-
zomii sexuali au fost gsite n 23 de cazuri (6,44%) din totalul cariotipurilor efectuate. Cel mai frecvent
rezultat citogenetic a fost monosomia X (5 cazuri). Incidena anomaliilor structurale implicnd cromo-
zomul X sau Y a fost n studiul nostru de 26,08%. Modificrile cromozomiale omogene au fost
prezente la 78,27% din cazuri, iar la restul de 21,73% s-a evideniat un mozaicism. n cazuistica
noastr au fost prezente i cazuri extrem de rare, descrise n numr limitat n literatura de specialitate,
printre care amintim: 49,XXXXY; mozaicism: 45,X/47,XYY sau o translocaie implicnd cromozomul
X i un autozom prezent la mai muli membrii ai unei familii. La sexul feminin examenul citogenetic
a fost solicitat cel mai frecvent datorit hipostaturii sau amenoreei primare iar la sexul masculin hipo-
gonadismul sau infertilitatea au reprezentat fenotipul predomaniant.
C28. Molecular Mechanisms of Spinal Muscular Atrophy

Todoran-Butil Anamaria1,2, Pacanu Ionela1,3, Csep Katalin1, Bnescu Claudia1
1. Dept. of Genetics, University of Medicine and Pharmacy Trgu-Mure; 2. Paediatric
Neurology and Psychiatry Clinic Trgu-Mure; 3. Endocrinology Clinic Trgu-Mure
Spinal muscular atrophy is an autosomal severe neuromuscular disease characterized by degen-
eration of motor neurons in the spinal cord, which results in progressive proximal muscle weakness
and paralysis. To date, the disease can be classified into four main categories based on severity and age
of onset. Type 1 spinal muscular atrophy (Werdnig-Hoffmann) is characterized by severe, generalized
muscle weakness and hypotonia at birth or within the first 3 months. Death from respiratory failure
usually occurs within the first 2 years. Children with type 2 survive beyond 4 years and are able to sit,
although they cannot stand or walk unaided. Type 3 (Kugelberg-Welander) is a milder form, with onset
during infancy or youth; these patients learn to walk unaided. Adult-onset spinal muscular atrophy,
type 4, is less common but has also been reported, does not affect life expectancy.
Spinal muscular atrophy is caused by a mutation of the survival motor neuron gene (SMN) on
chromosome 5 which exists in 2 nearly identical copies (SMN1 and SMN2). Exon 7 of SMN1 is ho-
mozygously absent in about 95% of spinal muscular atrophy patients, whereas the loss of SMN2 does
not cause spinal muscular atrophy. Small mutations are found in the other 5% of affected patients.
SMN1 dosage testing can be used to determine the SMN1 copy number and to detect spinal muscular
atrophy carriers and affected compound heterozygotes.
There is a high mortality rate in infancy and severe morbidity in childhood. Management de-
pends on treating or preventing complications of weakness and maintaining quality of life. Weakness
may affect several organ systems: respiratory, due to restrictive lung disease; gastrointestinal, in terms
of dysphagia and constipation; and orthopedic, with progressive deformities.
Keywords: spinal muscular atrophy, motor neuron, survival motor neuron (SMN)
Mecanisme moleculare ale atrofiei musculare spinale

Todoran-Butil Anamaria1,2, Pacanu Ionela1,3, Csep Katalin, Bnescu Claudia
1. Dept. de Genetic, UMF Trgu-Mure; 2. Clinica de Neurologie Pediatric i Psihiatrie
Trgu-Mure; 3. Clinica de Endocrinologie Trgu-Mure
Atrofia muscular spinal este o boal autozomal recesiv care afecteaz neuronii motori perifer-
ici din maduva spinrii, cu apariia unui deficit motor proximal al membrelor care duce la o invaliditate
ce progreseaz n funcie de tipul de afeciune. Se clasific n 4 tipuri: Tipul I - forma sever infantil,
boala Werdnig- Hoffmann, cu debut la natere pna la 3 luni, cu slbiciune muscular generalizat i
mare hipotonie. Decesul poate surveni n urma complicaiilor respiratorii pna la vrsta de 2 ani. Tipul
II - forma intermediar - copiii supravieuiesc peste vrsta de 4 ani, menin poziia eznd, dar nu pot
merge singuri. Tipul III - Kugelberg-Welander, forma uoar, juvenil: copiii achiziioneaz mersul in-
dependent, avnd prognosticul cel mai bun. Tipul IV forma adult, cu evoluie lent i care nu
afecteaz sperana de via.
Amiotrofia spinal este cauzat de mutaii ale genei SMN - survival motor neuron care este
prezent pe cromozomul 5. Exist dou gene implicate n producerea bolii (SMN1 i SMN2). Cea mai
important este gena SMN1, n 95% din cazurile de amiotrofie spinal cauza bolii este o anumit
mutaie n aceast gen (lipsa exonului 7 din ambele copii ale genei). Gena SMN2 nu produce direct
boala ci regleaz severitatea ei prin numrul de cpii prezente. Doar n 5% din cazuri boala se poate
datora unor mutaii punctiforme. Pentru ca boala s se produc e nevoie ca ambele cpii ale genei
SMN1 s fie mutante (stare homozigot), n caz contrar persoana este doar purttoare.
Exist o rat crescut de mortalitate n rndul formelor I i II n perioada de sugar i n mica
copilrie. Managementul amiotrofiilor spinale const n prevenirea i combaterea complicaiilor pentru
a asigura pacientului o via ct mai lung i de o calitate ct mai bun. Din pcate, la ora actul nu ex-
ist dect tratament suportiv. Complicaiile care pot s apar sunt de tipul infeciilor respiratorii,
gastrointestinale, n special disfagia, constipaia, deformri scheletice, anchiloza articulaiilor.
Cuvinte cheie: atrofie muscular spinal, neuron motor, gena de supravieuire a neuronului mo-
tor (SMN).
C29. Iasi Medical Genetics Centers experience concerning diagnosis and

management of mentally retarded patients
Rusu Cristina1, Negur Lucian2, Ivanov Iuliu2, Volociuc Mihail1, Gorduza Vlad2, Covic
Mircea1
1. Medical Genetics Centre, Sf Maria Childrens Hospital, Iasi, Romania; 2. Immunology
and Genetics Lab, Specialty Outpatient Unit, Sfntul Spiridon Hospital, Iasi, Romania
Mental retardation (MR) is a frequent category of pathology, affecting 3% of the general popula-
tion. Causes are very different and vary according to MR severity. Baseline intellectual development
and mild MR are mainly due to social causes, whereas moderate and severe forms of MR have mainly
genetic determinism. Genetic causes of MR include chromosomal abnormalities, monogenic disorders
(especially X-linked mental retardation with the most frequent form, Fragile X Syndrome), as well as
multifactorial causes. We present the protocol introduced in Iasi Medical Genetics Centre for the evalu-
ation of children and families with MR. The protocol includes the following sequence: recording of
anamnestic data, complete physical examination and application of diagnostic scores. Selected cases
follow sequential genetic testing (karyotype; antiFMRP test for Fragile X Syndrome screening and
PCR test to confirm the diagnosis; MLPA test to screen for subtelomeric rearrangements (as cause of
non-specific MR) and microdeletions and FISH test to confirm identified anomalies. The protocol in-
cludes both management of the patient and the family. Optimization and economic efficiency of the
protocol is discussed. Finally, future directions to extend evaluation of MR patients, adequate to the
situation existent in Romania, are presented.
Experiena Centrului de Genetic Medical Iai privind diagnosticul i

managementul pacienilor cu retard mintal
Rusu Cristina1, Negur Lucian2, Ivanov Iuliu2, Volociuc Mihail1, Gorduza Vlad2, Covic
Mircea1
1. Cabinetul de Anomalii Congenitale i Boli Genetice, Spitalul de Copii Sf Maria, Iai; 2.
Laboratorul de Imunologie i Genetic, Ambulatorul de Specialitate al Spitalului Sfntul
Spiridon, Iai
Retardul mintal (RM) este o categorie frecvent de patologie, afectnd 3% din populaia gener-
al. Cauzele sunt foarte diferite i variaz n funcie de severitatea RM. Intelectul liminar i RM uor au
frecvent cauze sociale, spre deosebire de RM moderat i sever unde determinismul genetic este pre-
ponderent. Cauzele genetice de RM includ anomalii cromozomiale, boli monogenice (n special retar-
dul mintal legat de X), dar i cauze multifactoriale. Prezentm protocolul introdus n Centrul de Genet-
ic Medical Iai pentru evaluarea copiilor i familiilor cu retard mintal. Protocolul include nregis-
trarea datelor anamnestice, examenul clinic complet i aplicarea de scoruri de diagnostic. La cazurile
selectate se aplic testarea genetic secvenial (cariotip; test antiFMRP pentru screeningul pacienilor
cu Sindrom X fragil i test PCR pentru confirmarea diagnosticului; test MLPA pentru screeningul rear-
anjamentelor subtelomerice i al microdeleiilor i test FISH pentru confirmarea anomaliilor respect-
ive). Protocolul include managementul pacientului, dar i al familiei. Este discutat optimizarea, pre-
cum i eficiena economic a acestui protocol. n final sunt prezentate direciile viitoare de extindere a
evalurii pacienilor cu RM, adecvat situaiei existente n Romnia.
Haemostasis
R31. An update of the laboratory diagnosis of inherited thrombophilia;
difficulties and new possibilities
Bereczky Z1, Bagoly Z1, Pusks A2, Muszbek L1
1. Clinical Research Center, University of Debrecen, Medical and Health Science Center,
Debrecen, Hungary, 2. Medical and Pharmaceutical University of Trgu Mure, 2nd
Department of Medicine
Major causes of inherited thrombophilia are antithrombin III (AT-III), protein C (PC), protein S
(PS) deficiencies, activated protein C (APC) resistance caused by factor V (FV) Leiden mutation, and
prothrombin 20210A allele. Elevated FVIII activity, elevated homocysteine level and lipoprotein(a) are
considered as minor contributors. As combined thrombophilia is frequently found in the background of
deep vein thrombosis (DVT) and pulmonary embolism (PE) occurring at relatively young age, or at re-
peated occasions, or when DVT occurs at unusual site, it is of high importance to determine the whole
thrombophilia panel.
The first line tests for the diagnosis of AT-III and PC deficiencies are functional tests, determin-
ation of antigen levels are only required for classification. For the determination of AT-III deficiency a
chromogenic tests based on the inhibition of activated FX (FXa), rather than tests based on the inhibi-
tion of thrombin, are recommended. For first line PC assay the clotting test is superior to the chromo-
genic one. It is of high importance to exclude acquired, transient deficiencies, which frequently re-
quires repeated investigation after 1-3 month. The reference intervals for AT-III and PC functional
tests are 80-120% and 70-140%, respectively. A significant problem with AT-III and PC assays is the
considerable overlapping of the activities measured in healthy individuals and in patients heterozygous
for these deficiencies. As the diagnosis has important (sometimes life-long) consequences on the dura-
tion of anticoagulant therapy and on the life style of the patient, in the case of borderline values we per-
form sequencing of AT-III or PC genes to prove or exclude the presence of thrombophilia.
The diagnosis of PS deficiency represents special diagnostic difficulty. The recommended func-
tional assay is a clotting test, however FV Leiden mutation in a number of cases interferes with this as-
say. As FV Leiden mutation frequently occurs in the Central-eastern European populations (its preval-
ence is 10% in Hungary), this is a serious problem. For this reason, determination of both PS activity
and free PS antigen at the same time is recommended. If both PS activity and free antigen are low then
the diagnosis is type I PS deficiency. However, if low activity and normal antigen levels are measured,
which would normally indicate type II PS deficiency, this diagnosis can be accepted only in the ab-
sence of Leiden mutation. If Leiden mutation is present the only remaining resource is sequencing the
PS gene. Unfortunately, there is a pseudogene, which has 97% sequence identity with the PS gene and
makes the molecular genetic diagnostics of PS deficiency rather difficult. We have designed a sequen-
cing method that eliminates the problem caused by the pseudogene, and established that in a high per-
centage of patients diagnosed with type II PS deficiency, the decreased PS activity is due to interfer-
ence by FV Leiden mutation and these patients are exempt of PS deficiency. We tested 14 phenotypic-
ally type II PS deficient patients who had Leiden mutation and none of them had genetic defect in the
PS gene. Another important point is that due to the significant decrease of PS level during pregnancy,
the deficiency cannot be diagnosed in pregnant women.
The molecular genetic diagnosis of FV Leiden mutation and prothrombin 20210A allele is well
established. Here the question is, how the functional APC resistance test performs. Such test is avail-
able for laboratories that do not have the facility to perform molecular genetic tests. Besides, the func-
tional test can detect very rare cases of APC resistance not due to FV Leiden mutation. We found that
the specificity of an appropriate functional APC resistance assay with well established cut-off value is
excellent and can detect practically 100% of Leiden mutants. Pseudohomozygous (hemizygous) pa-
tients represent a special rare group of FV Leiden mutation. These patients are heterozygous for FV de-
ficiency and have only a single FV allele with Leiden mutation. The risk of these patients for throm-
boembolic events corresponds to the risk of patients possessing the homozygous form of Leiden muta-
tion.
R32. Aspirin resistance and its laboratory diagnostics

Muszbek L. Kovcs E, Bereczky Z
Clinical Research Center, University of Debrecen, Medical and Health Science Center,
Debrecen, Hungary
Acetylsalicylic acid (ASA; Aspirin) has been used in human therapy since 1899 and it was intro-
duced in the prevention of atherothrombotic complication in the middle of the last century. By inhibit-
ing platelet function, low dose Aspirin prevention decreases the occurrence of myocardial infarction by
34% and that of stroke by 25%. Its main effect is the acetylation of a serine residue (Ser529) in the cyc-
looxygenase (COX) 1 enzyme. This way it prevents the access of arachidonic acid (AA) to the active
site of the enzyme and blocks the formation of cyclic endoperoxides, consequently the formation of the
highly effective platelet activating compound, thromboxane A2 (TXA2). It is a clinical observation that
in part of the patients ASA is not able to prevent the onset of acute thromboembolic complications. A
number of laboratory tests have been developed to identify individuals resistant to the effect of ASA.
Detection of ASA resistance has a significant impact on the course of therapy and it also has health
economic implications.
In theory there are three different types of ASA resistance:
Chemical resistance; the lack of acetylation at Ser529 of COX1 in platelets.
Laboratory resistance; the lack of the detection of ASA effect by a laboratory method.
Clinical resistance; the ineffectiveness of ASA to prevent acute atherothrombotic complic-
ation in a patient.
No laboratory method is available to detect the chemical resistance and clinical resistance can be
established only retrospectively. Thus, the measurement of laboratory resistance remains the only tool
to detect the ineffectiveness of ASA. However, there are several problems with measuring laboratory
ASA resistance. Various laboratory methods give widely different results and the occurrence of ASA
resistance, as estimated by different methods, varies between 5-30%. There has not been a reference
method to which different methods used for testing ASA resistance can be compared to establish their
validity. Finally, their is no large scale prospective study that compares clinical and resistance meas-
ured by laboratory methods.
We developed a so called reference method for the determination of ASA resistance, which is
too cumbersome for everyday laboratory use, but closely relates to chemical resistance and suitable for
testing the validity of routine laboratory methods in establishing ASA resistance. The principle of the
reference method is the measurement of the inactive metabolite of TXA2 (TXB2) formed in platelet rich
plasma following platelet activation by AA. In this assay the measurement of TXB2 by ELISA is pre-
ceded by the solid phase separation of TXB2 from AA present in the assay mixture in huge amount. Us-
ing this method we evaluated the validity of the following laboratory methods commonly used for the
detection of ASA resistance: platelet aggregation induced by ADP, epinephrine, collagen and AA,
platelet secretion induced by the same agents and detected by bioluminescence measurement of re-
leased ATP, PFA-100 closure time and Verify Now Aspirin test. ADP, epinephrine and collagen ag-
gregation gave high percentage of false positive results and they are not recommended for testing ASA
resistance. AA-induced aggregation and secretion as well as the Verify Now Aspirin test performed
with the highest validity rate. It will be important to explore clinical resistance in a prospective study
and compare it with the laboratory resistance determined by the best performing tests.
R33. Anticoagulant mechanisms in the postoperative state

Brudac Ioana 1, Cucuianu Mircea1, Colhon D.M. 2
1. Uniuversity of Medicine and Pharmacy Iuliu Haieganu Cluj Napoca; 2. Central
Laboratory, County Clinical an Emmergency Hospital Cluj
Protein C (PC) and its cofactor protein S (PS), as well as antithrombin III (AT III) are potent
physiological anticoagulant mechanisms. As thrombotic events are known to be a major complication
of the surgical procedures, we studied the behavior of these anticoagulant mechanisms in surgical pa-
tients. PC:Ag level was significantly decreased (63,3 4,2, p< 0,001) in 29 critically - ill surgical pa-
tients when compared to 32 healthy control subjects. When compared to 10 controls subjects, PS:Ag
was also significantly decreased (59,2 4,96, p< 0,01) in 12 surgical patients in critical condition. In
a group of 16 critically ill surgicall patients AT III activity was at the inferior limit of normal values
(83% 2,5, p< 0,001), when compared to 22 healthy control subjects. Decreased levels of PC and
PS:Ag can be explained by the switch of the hepatic protein synthesis during the acute phase reaction
developing in critically ill surgical patients towards the increased production of acute phase proteins,
while reducing the secretion of PC and PS, cholinesterase and albumin. The less important decrease of
AT III can be explained by the fact that it is synthesized not only in the liver but also by the endothelial
cells. These observations emphasize the risk for thrombosis in postoperative states and stress the im-
portance of a thorough investigation of hemostasis in surgical patients.
Comportarea unor mecanisme anticoagulante la pacieni n stare

postoperatorie
Brudac Ioana 1, Cucuianu Mircea1, Colhon D.M. 2
1. UMF Iuliu Haieganu Cluj Napoca; 2. Laborator Central Spitalul Clinic Judeean de
Urgen Cluj
Proteina C (PC) i cofactorul ei, proteina S (PS), precum i antitrombina III (AT III) reprezint
mecanisme anticoagulante fiziologice importante. ntruct evenimentele trombotice reprezint o com-
plicaie major a interveniilor chirurgicale, am studiat comportamentul acestor mecanisme anticoagu-
lante la pacieni chirurgicali n stare postoperatorie. Nivelul PC:Ag a fost semnificativ sczut (63,3
4,2, p< 0,001) la 29 pacieni chirurgicali n stare critic comparativ cu un lot martor de 32 de subieci.
PS:Ag a fost de asemenea sczut semnificativ (59,2 4,96, p< 0,01) la 12 pacieni chirurgicali n stare
critic. ntr-un grup de 16 pacieni chirurgicali n stare critic, activitatea AT III s-a situat la limita in-
ferioar a normalului (83% 2,5, p< 0,001), comparativ cu lotul de 22 subieci de control. Nivelele
sczute de PC i PS:Ag s-ar putea explica prin comutarea proteosintezei hepatice n cadrul reaciei de
faz acut spre producia de proteine de faz acut, cu scderea sintezei de PC, PS, albumin i colin-
esteraz. Scderea mai puin marcat a activitii AT III s-ar explica prin producerea ei nu doar de ctre
ficat ci i de ctre celulele endoteliale. Aceste observaii subliniaz riscul apariiei trombozei n starea
postoperatorie i necesitatea unui bilan mai aprofundat al hemostazei n aceste cazuri.
Microbiology
R35. Serological investigations in communicable diseases. Limits and
perspectives
Negut M., Rafila A., Ionescu G.
Carol Davila University of Medicine and Pharmacy Bucharest
The scope of serological investigations has been extended, inevitably, to emergent etiologies, be-
cause of the clinical interest for a correct etiologic diagnostic, as well as the epidemiologic concern for
public health.
Though the conventional methods for serological diagnostic are widely used, the world-wide
trend is automatization, using large capacity equipments based on the principles of existing methods or
on new principles and technologies, including nanotechnology.
Consequently, the diagnostic will be concentrated in large laboratories, with the needed logistics
for rapid transportation and reception of a huge volume of samples and for result transmission, which is
nowadays solved by means of internet and secure data transmission.
Worth mentioning are the efforts and the competition between the providers of equipments and
reagents concerning the shortening of the interval between research only and in vitro diagnostic,
concurrently with the improvement of the performances (sensitivity, specificity, predictive values), im-
posed by the implementation of quality management systems. There are still some limits concerning
the reagents and technologies in use, the small number of cases (for instance when dealing with rare
diseases), the lack of control panels and of intercomparation schemes.
Another direction is that of developing tests for rapid diagnostic, useful for both screening and
emergency situations, including bioaggression.
Yet, an acceptable compromise must be found between the high costs of new technologies and
the limited funds assigned to public health.
Determinrile serologice n bolile transmisibile. Limite i perspective

Negu M., Rafila A., Ionescu G.
Universitatea de Medicin i Farmacie Carol Davila Bucureti
Sfera de aplicabilitate a determinrilor serologice s-a extins inevitabil i asupra etiologiilor emer-
gente, att datorit interesului clinic pentru un diagnostic etiologic corect ct i a celui epidemiologic
pentru sntatea public.
Dei la noi sunt nc larg utilizate metodologiile convenionale de diagnostic serologic, tendina
pe plan mondial este de automatizare, folosind echipamente de mare capacitate, bazate pe principiile
metodelor existente sau pe principii i tehnologii noi, inclusiv nanotehnologii.
Consecina va fi concentrarea diagnosticului n laboratoare mari, cu logistica necesar pentru
transportul rapid i recepia unui volum mare de probe i pentru comunicarea la distan a rezultatelor,
problem rezolvabil astzi datorit internetului i mijloacelor de transmitere securizat a datelor.
Se remarc eforturile i concurena acerb ntre productorii de echipamente i reactivi de dia-
gnostic, de reducere a timpului de la stadiul de dispozitive research only la cel de in vitro diagnost-
ic, concomitent cu mbuntirea performanelor (sensibilitate, specificitate, valori predictive), cerine
determinate de introducerea sistemelor de management al calitii. Exist ns limitri legate de mater-
ialele i tehnologiile folosite, de numrul mic de cazuri (vezi bolile rare), de lipsa panelurilor de control
i a schemelor de intercomparare.
O alt direcie de aciune este cea de dezvoltare a unor teste de diagnostic rapid, utile att pentru
screening ct i n situaii de urgen inclusiv de bioagresiune.
Rmne ns de gsit un compromis acceptabil ntre costurile ridicate ale noilor tehnologii i re-
sursele limitate alocate sntii publice.
C36. Congenital syphilis guidelines for laboratory diagnosis

Ionescu D., Ionescu G., Bncescu A.
INCDMI Cantacuzino
University of Medicine and Pharmacy Carol Davila Bucharesi
According to ECDC report/2008 Romnia had a highest notification rate for syphilis in 1996,
with 26.2 cases per 100.000.
This high syphilis morbidity figure has a direct impact on congenital syphilis incidence. Congen-
ital treponemal infection continues to produce an adverse outcome of pregnancy with frequent fetal and
neonatal death.
The main obstacle in the prevention activity is the inefficiency of the surveillance system to tar-
get the groups of pregnant women with high prevalence of syphilis.
The leading factor accounting for the failure to prevent congenital infection is the lack of prenat-
al care. So the antenatal syphilis screening (VDRL, TPHA) and treatment is the most valuable tool for
prevention or elimination of congenital syphilis.
The methodology for laboratory diagnosis of congenital syphilis is considered related to several
possible scenarios.
Sifilisul congenital - principiile diagnosticului de laborator

Ionescu D., Ionescu G., Bncescu A.
INCDMI Cantacuzino
Universitatea de Medicin i Farmacie Carol Davila Bucureti
Romnia ocup primul loc n Europa privind infecia sifilitic, cu 5661 cazuri confirmate n
1996, adic 26.2 cazuri la 100.000 locuitori, cifra cu influen direct asupra incidenei sifilisului
congenital. Acesta form clinic rmne n continuare o important cauz de morbiditate infantil i
chiar mortalitate fetal i neonatal.
Obstacolul major care frneaz activitatea preventiv este incapacitatea sistemului de
supraveghere de a identifica femeile infectate, deoarece grupurile de risc din care fac parte
(adolescente, necsatorite, prostituate, consumatoare de droguri) sunt greu accesibile pentru depistare
i tratament.
Screening-ul nainte de sarcin sau n primul trimestru i cel trziu n trimestrul al doilea,
(VDRL/RPR,TPHA) i instituirea imediat a tratamentului penicilinic reprezint o strategie de departe
cost-efectiv.
Cu tot tratamentul, la aproximativ 14% dintre gravide se nregistreaz fie moarte fetal, fie
naterea de copii cu sifilis congenital.
n Romnia, funcioneaz un Program de supraveghere al ITS, dar aplicarea lui n practic nu are
eficiena dorit (eludarea semnelor clinice, necunoaterea antecedentelor materne, subtilitile tehnice
ale diagnosticului, lipsa de comunicare etc.), motiv pentru care valorile reale ale morbiditii sifilisului,
n general i a celui congenital, n special, continu s nu se suprapun pe cifrele raportate.
C37. Antibody avidity testing and its significance in laboratory diagnosis

Ncuiu Alexandra Maria
Carol Davila University of Medicine and Pharmacy / NIRDMI Cantacuzino, Bucharest
Traditional serological testing (testing for IgM and IgG antibodies titre) can trigger some prob-
lems of interpretation, especially when IgM values are positive. A positive titre for IgM antibodies
does not necessarily mean a primo-infection upon testing. It might be the expression of an acute on-go-
ing infection (reactivation of previous infection or reinfection), but might be a sign of cross-reaction or
of non-specific polyclonal stimulation of the immune system. When IgG antibodies are present in the
serum, the avidity index might be calculated, which might establish the moment when the infection
was first acquired. The method consists in testing the same serum twice, once by adding a buffer con-
taining a denaturant agent (urea, diethylamine etc) which disrupts the bonds established by low avidity
antibodies. The test is important especially when evaluating the immune status of pregnant women in
their first trimester of pregnancy, which tested positive for IgM antibodies against a series of poten-
tially teratogenic germs (rubella virus, cytomegalovirus, Toxoplasma gondii). The avidity test might as
well be useful when IgM values are negative due to their very short persistence in the serum or due to a
high detection threshold. Beside this avidity test kits used for establishing the moment of acquisition of
teratogenic infections, other avidity tests are available which can complete the serological profile of in-
fections with HIV, hepatitis, Epstein Barr or West Nile viruses, with Borellia burgdorferi or with Fas-
ciola hepatica, Schistosoma spp. or those of some auto-immune diseases.
Testul de aviditate - semnificaii n diagnosticul de laborator

Ncuiu Alexandra - Maria
"Carol Davila" / INCDMI Cantacuzino Bucureti
Testarea serologic tradiional (determinarea titrului anticorpilor IgM i IgG) poate ridica un-
ele probleme de interpretare, cu precdere n situaiile n care valoarea anticorpilor IgM este pozitiv.
Un titru pozitiv pentru IgM nu semnific obligatoriu o primo-infecie n momentul testrii. Poate fi ex-
presia unei infecii acute, n desfurare (a unei reactivri sau a unei reinfecii), dar poate aprea i ur-
mare a unei reacii ncruciate sau a unei stimulri policlonale nespecifice a sistemului imun. n cazul
n care anticorpii de clas IgG sunt prezeni n ser poate fi calculat indicele de aviditate care poate situa
n timp momentul primo-infeciei. Cu ct indicele de aviditate este mai sczut, cu att primo-infecia
este mai recent. Metoda presupune testarea aceluiai ser n dublu, una din testri fcndu-se prin
adugarea unui tampon ce conine un agent denaturant (uree, dietilamin) ce rupe legturile stabilite de
anticorpii de joas aviditate. Testul are importan deosebit cu precdere n evaluarea statusului imun
al gravidelor aflate n primul trimestru de sarcin, diagnosticate cu anticorpi de clas IgM prezeni m-
potriva unor germeni potenial teratogeni (virusul rubeolos, citomegalovirusul, Toxoplasma gondii). De
asemenea testul de aviditate poate fi util i atunci cnd valoarea IgM este negativ datorit persistenei
foarte scurte n ser sau datorit unui prag de detecie prea crescut. Pe lng trusele de aviditate folosite
pentru datarea acestor infecii teratogene, sunt disponibile i teste de aviditate care pot completa profil-
ul serologic al infeciilor cu virusuri HIV, hepatice, Epstein-Barr sau West Nile, cu Borellia burgdor-
feri sau Fasciola hepatica, Schistosoma spp. sau al unor boli auto-imune.
R38. Antimicrobial susceptibility testing new recommendations and

implications for the clinical laboratory and public health system
Codi Irina
NIRDMI Cantacuzino
Though practiced since decades, Antimicrobial Susceptibility Testing (AST) remains the corner
stone of a bacteriology laboratory.
We are confronted not only with increasing demands in respect of ensuring the test parameters,
but also with an alert moving and changing of standards, rules, breakpoints and requirements.
On our knowledge, most of Romanian laboratories used to work according to the CLSI
(formerly NCCLS U.S.A.) standard and few of them according to the CA-SFM (Comit de l'Anti-
biogramme de la Socit Franaise de Microbiologie).
EUCAST (European Committee for Antimicrobial Susceptibility Testing) is the European regu-
latory body for AST standardization, affiliated to the ESCMID (European Society of Clinical Microbi-
ology and Infectious Diseases) since 2002 and organized now by ESCMID, ECDC (European Centre
for Disease Control) and national breakpoint committees. Since 2006, EUCAST is publishing normat-
ive documents to be used in the European clinical laboratories.
We are discussing some issues linked with the EUCAST recommendations regarding:
clinical and microbiological/epidemiological antimicrobial resistance definition
EUCAST breakpoints for different antimicrobial/microorganism combinations
developing the disc diffusion European standard, forecasted for the end of the 2009
antimicrobial susceptibility testing by automated methods
These new rules are requiring local and national reactions, in order to ensure accurate and com-
patible results at the European level.
We have to keep in mind that behind the immediate value of these results, which is recovered
from adjusting the therapeutic approach in case of first intention, empirical treatment failure, AST res-
ults are representing a public thesaurus of inestimable value for grounding antimicrobials consumption
policy at local, national and European level.
Testarea sensibilitii la antibiotice noi recomandri i implicaii n

laboratorul clinic i sntatea public
Codi Irina
INCDMI Cantacuzino
Dei se practic de mai multe zeci de ani, testarea sensibilitii la antibiotice (TSA) rmne
proba de ncercare ntr-un laborator de bacteriologie.
Suntem confruntai nu numai cu cerine mereu noi n ceea ce privete asigurarea parametrilor de
testare, dar i cu o dinamic alert a standardelor, regulilor, punctelor de ruptur i altor parametri.
Dup cunotinele noastre, majoritatea laboratoarelor din Romnia lucreaz conform
standardului CLSI (Clinical Laboratory Standards Institute), fost NCCLS-USA (National Committee
for Clinical Laboratory Standards - SUA) i numai cteva conform standardului CA SFM (Comit de
l'Antibiogramme de la Socit Franaise de Microbiologie).
EUCAST (European Committee for Antimicrobial Susceptibility Testing) este forul metodologic
european pentru standardizarea TSA, afiliat ESCMID (European Society of Clinical Microbiology and
Infectious Diseases) din 2002 i organizat n prezent de ESCMID, ECDC (European Centre for
Disease Prevention and Control) i comitetele naionale pentru puncte de ruptur. Din 2006, EUCAST
public documente metodologice cu valoare normativ la nivel european.
Sunt discutate o serie de aspecte cuprinse n recomandrile EUCAST cu privire la:
definiia sensibilitii la antibiotice din punct de vedere clinic i din punct de vedere
microbiologic sau epidemiologic
punctele de ruptur stabilite de EUCAST pentru diverse combinaii antibiotic/microorganism
dezvoltarea standardului european pentru metoda difuzimetric, previzionat pentru sfritul
anului 2009
testarea sensibilitii la antibiotice prin metode automatizate
Aceste noi reglementri necesit reacii la nivel local i naional, n scopul obinerii unor
rezultate corecte i compatibile la nivel european.
Nu trebuie uitat faptul c dincolo de valoarea imediat a acestor rezultate, care se regsete n
posibilitatea de ajustare a schemei terapeutice pentru cazurile de eec al terapiei de prima intenie,
rezultatele TSA reprezint un tezaur public de mare valoare pentru fundamentarea politicilor de
consum al antibioticelor la nivel local, naional i european.
C39. Biorisk management a new approach

Ionescu G.1, Negu M.2, Rafila A.2
1. INCDMI Cantacuzino; 2. University of Medicine and Pharmacy Carol Davila Bucharest
Ensuring biosecurity and biosafety in laboratories which handle pathogens or materials contam-
inated with them, was of interest to national authorities and international organizations who have such
concerns, in last years.
The trend has imposed especially after events in the United States in 2001 and brought public at-
tention to the risk of bioterrorist attacks.
In addition to the classical measures concerning the two concepts, which are particularly the re-
sponsibilities of the management of these laboratories and of each worker, has crystallized the concept
of biorisk management which required a systematic approach, worldwide.
Starting from the WHO guide Biorisk management Laboratory biosecurity guidance, which
drew large lines of action, had occurred quickly the need for standardization in this field in a uniform
and consistent manner, according with other management systems of an organization.
Following Deming PDCA model applied to quality and environment management systems, ac-
cording to the ISO 900x family of standards, ISO 17025 and ISO 15189 (standards for accreditation of
laboratories), CEN, European standardisation body, has developed the standard CWA 15793:2008.
Bringing Romania to European Union standards we considered useful to know of these provi-
sions by all medical specialists, laboratory specialists in particular.
The paper presents the main concepts and steps to be taken, responsibilities in implementing and
tracking their implementation, as derived from the document noted.
Managementul bioriscului o nou abordare

Ionescu G.1, Negu M.2, Rafila A.2
1. INCDMI Cantacuzino; 2. Universitatea de Medicin i Farmacie Carol Davila Bucureti
Asigurarea biosiguranei i biosecuritii laboratoarelor n care se manevreaz microorganisme
patogene sau materiale contaminate cu acestea a intrat n ultimii ani n sfera de interes a autoritilor
naionale i a organizaiilor internaionale ce au acest tip de preocupri. Tendina s-a impus mai ales
dup evenimentele petrecute n Statele Unite n 2001 i care au adus n atenia opiniei publice riscul
producerii de atacuri bioteroriste.
Pe lng msurile clasice care fac obiectul celor dou noiuni, i care stau n special n re-
sponsabilitatea managementului acestor laboratoare dar i al fiecrui lucrtor, s-a cristalizat conceptul
de management al bioriscului care a necesitat o tratare sistematic, pe plan mondial.
Plecndu-se de la ghidul OMS care a trasat direciile mari de aciune, a aprut rapid i necesit-
atea standardizrii n acest domeniu, ntr-o abordare unitar i n concordan cu celelalte sisteme de
management ale unei organizaii. Urmnd modelul Deming PDCA, aplicat la sistemele de management
al calitii i mediului, n conformitate cu familia de standarde ISO 900x, dar i cu standardele de
acreditare ale laboratoarelor ISO 17025, 15189, organismul european de standardizare, CEN, a elaborat
standardul CWA 15793: 2008.
Prin prisma alinierii Romniei la standardele Uniunii Europene am considerat util cunoaterea
acestor prevederi de ntreg corpul medical i specialitii din laboratoarele noastre medicale n special.
Lucrarea prezint conceptele principale i msurile care trebuie luate, responsabilitile n apli-
carea i urmrirea aplicrii lor, aa cum decurg din documentul amintit.
C40. Characterization of the nosocomial and community-associated MRSA

isolates in Hungary 2001-2008
Ungvri Erika, Tth kos, Hajbel-Vkony Gabriella, Gacs Mria, Pszti Judit
National Center for Epidemiology, Department of Phage Typing and Molecular
Epidemiology, Department of Bacteriology
Objectives: According to the National Bacteriological Surveillance the proportion of in-
vasive MRSA isolates had risen from 4.7% in 2001 to 24.7% in 2008 in Hungary. The aim of
the study was to overview the molecular typing results of the nosocomial and community-ac-
quired MRSA strains received by the National Center for Epidemiology between 2001 and
2008.
Methods: A total of 608 MRSA isolates (534 from nosocomial outbreak investigation and inva-
sive infections; 74 as suspecious to be community-acquired MRSA (CA-MRSA)) were typed by SmaI
macrorestriction PFGE. All putative CA-MRSA isolates were tested by PCR for the presence of Pan-
ton-Valentine leucocidin (PVL) genes. PVL-positive CA-MRSA isolates were characterised by staphy-
lococcal cassette chromosome mec (SCCmec) type and spa type. Multilocus sequence typing (MLST)
was performed on representative isolates from each PFGE type.
Results: More than 80% of the isolates belonged to 4 predominant PFGE types. Type A and C
strains (n=238) belonged to the sequence type 5 (ST5) and carried SCCmec II. Type B strains (n=102)
belong to the ST228-MRSA-I clone. Type D strains (n=122) were identical to the EMRSA-15 clone
(ST22-MRSA-IV). Among putative CA-MRSA isolates 23 were PVL positive and harboured SCCmec
IV, out of which 17 isolates showed closely related PFGE pattern and belonged to the ST80. The re-
maining 6 isolates belonged to three genotypes, ST8-MRSA-IV, ST30-MRSA-IV and ST37-MRSA-
IV.
Conclusion: Our results showed that 3 epidemic MRSA clones have spread in the Hungarian
hospitals in the study period. The PVL-positive CA-MRSA strains belonged to four different clones
with a predominance of the ST80-MRSA-IV clone.
C41. Staphylococcus aureus involved in bacteraemia in an emergency

university hospital
Szkely Edit1,2, Lrinczi Lilla1, Bilca Doina Veronica2, Fldes Annamria2, Voidzean
Septimiu3
1. Department of Microbiology, University of Medicine and Pharmacy, Tg. Mures;
2. Central Medical Laboratory, Mure County Emergency Clinical Hospital;
3. Department of Epidemiology and Preventive Medicine, University of Medicine and
Pharmacy, Tg. Mures
Culture confirmed S. aureus bacteremia cases were evaluated during a 3 year period in an emer-
gency university hospital. Incidence and blood culturing rates, patient and strain characteristics were
retrospectively analyzed from our laboratorys database. Clonal relations of methicillin-resistant S.
aureus (MRSA) strains were established by analyzing patterns of macrorestriction fragments of the
bacterial genom using PFGE (pulsed field gel electrophoresis).
In the period between 2005 and 2007 incidence rate of S. aureus bacteremia was 8 (6,5-9,5, CI
95%)/100000 hospital bed-days (BD), while that of MRSA was 5 (4-6, CI 95%)/100000 BD. Blood
culturing rate increased steadily from an average of 1,86 (1,48-2,26, CI 95%)/1000 BD in 2005 to 2,92
(2,48-3,34, IC 95%) /1000 BD in 2007 (p<0,001). The median age of patients with MRSA infections
was not significantly different from those with methicillin-susceptible S. aureus infections (52 vs 46
years, p=0,19). In case of MRSA strains, isolation from blood culture was associated with significantly
longer hospital stay prior sampling compared to methicillin-susceptible strains (17 vs 5 days, p<0,001).
Methicillin-resistance was present in 70% of 69 S. aureus strains. No resistance to glycopeptides was
detected by available testing methods. High level of susceptibility of MRSA strains was noted to
linezolid (100%), trimethoprim-sulfamethoxazol (96%) and chloramphenicol (97%). Other classes of
antibiotics were far less active against MRSA and multiresistance was present in 94% of strains. Out of
44 typed MRSA strains 41 belonged to the same clonal cluster.
Although there was a constant increase in blood culturing rate during the study period, it still re-
mained at a very low level which could had interfered with the correct evaluation of the incidence rate
of culture confirmed S. aureus bacteremia. MRSA bacteremia occurred after the first week of hospital-
ization. The clonal relatedness of invasive strains highlighted their common hospital origin.
Bacteriemii cauzate de Staphylococcus aureus ntr-un spital clinic judeean

de urgen
Szkely Edit1,2, Lrinczi Lilla1, Bilca Doina Veronica2, Fldes Annamria2, Voidzean
Septimiu1
1. Disciplina de Microbiologie, Universitatea de Medicin i Farmacie, Tg. Mures;
2. Laboratorul de Analize Medicale Central, Spitalul Clinic Judeean de Urgen, Tg. Mure;
3. Disciplina de Epidemiologie i Medicin Preventiv, Universitatea de Medicin i
Farmacie, Tg. Mures
S-au analizat cazuri de bacteriemie confirmate bacteriologic cauzate de S. aureus pe o perioad
de 3 ani ntr-un spital clinic judeean de urgen.
Rata incidenei, rata recoltrii hemoculturilor, caracteristicile pacienilor i a tulpinilor izolate s-
au studiat retrospectiv din baza de date a laboratorului. Relaiile clonale existente ntre tulpinile MRSA
s-au stabilit prin analiza fragmentelor de macrorestricie ale genomului bacterian prin metoda PFGE
(pulsed field gel electrophoresis).
n perioada 2005-2007 rata incidenei bacteriemiilor cauzate de S. aureus a fost de 8 (6,5-9,5, CI
95%)/100000 paturi-zile de spitalizare (PZ) iar cea a bacteriemiilor cauzate de MRSA 5 (4-6, CI 95%)/
100000 PZ. Rata recoltrii hemoculturilor a crescut n aceast perioad de la o medie de 1,86 (1,48-
2,26 CI 95%)/1000 PZ n 2005 la 2,92 (2,48-3,34, IC 95%)/1000 PZ n 2007 (p<0,001). Vrsta medie a
pacienilor cu infecii datorate tulpinilor meticilino-sensibile nu a fost semnificativ diferit de cea a pa-
cienilor cu infecii MRSA (46 vs 52 ani, p=0,19). Izolarea tulpinilor MRSA din hemocultur a fost
precedat de spitalizare de durat mai lung dect n cazul tulpinilor meticilino-sensibile (17 vs 5 zile,
p<0,001). Dintr-un numr total de 69 tulpini 70% au fost meticilino-rezistente. Nu s-a detectat
rezisten fa de glicopeptide prin metodele utilizate. S-a notat sensibilitatea tulpinilor MRSA fa de
linezolid (100%), trimetoprim-sulfametoxazol (96%) i cloramfenicol (97%). Celelalte clase de antibi-
otice au fost mai puin active fa de MRSA iar multirezistena a fost ntlnit la 94% dintre tulpini.
Din 44 de tulpini tipizate, 41 au aparinut aceluiai grup clonal.
Dei rata recoltrii hemoculturilor a crescut pe durata celor trei ani, aceasta a rmas la un nivel
redus ceea ce poate interfera cu evaluarea corect a ratei de inciden a bacteriemiilor confirmate bac-
teriologic. Bacteriemiile datorate MRSA au aprut n general pe durata celei de a doua sptmni de
spitalizare. Relaiile clonale existente ntre izolatele MRSA subliniaz sursa comun spitaliceasc a lor.
C42. Bacterial ethiology and drug resistance pattern of bacteria isolated

from blood cultures
Man A.; Szekely Edit; Mare Anca; Toma Felicia
Microbiology Departement, University of Medicine and Pharmacy Tg.Mure
Purpose: The evaluation of the etiology of bacteraemic associated diseases in Emergency
County Hospital of Tg. Mure (ECH) and the antibiotic susceptibility of the isolated germs from blood
cultures in 2008.
Materials and methods: There were processed 497 positive blood cultures from patients admit-
ted in ECH during 2008. Only one sample from each patient has been considered. The isolated germs
were identified and tested for antibiotic susceptibility following standard protocols.
Results: The following bacterial species were identified: coagulase-negative staphylococci
(CNS) (50%), Staphylococcus aureus (9%), E. coli (9%), Enterococcus spp. (7%), Acinetobacter spp.
(6%), Pseudomonas spp. (4%), other species (24%). As the blood culture was obtained in only one
sample and the diagnostic criteria for CNS involvement in bacteriemia could not be followed, there is
no relevance regarding the isolated CNS. 55% of S. aureus strains were methicillin-resistant (MRSA).
The MRSAs were isolated mainly from intensive care units ICUs (87%) and surgical departments
(57%). The staphylococci remain sensitive to phenicols, cotrimoxazole, glycopeptides and linezolid
(100%); regarding the resistance spectrum, a significant statistical difference was noticed between ICU
and medical departments (multi-resistant strains in ICU). From enterobacteria, the majority (42%) was
represented by E. coli (42%), Enterobacter spp. (19%), Klebsiella spp. (17%), others (22%). The en-
terobacteria are resistant to ampicillin (88%) and sensible to carbapenems (100%).
Conclusion: The most common bacteria isolated from blood cultures were staphylococci and en-
terobacteria. In ICUs and in medical units, where invasive procedures are frequently applied, the most
incriminated pathogen is methicillin-resistant Staphylococcus. The isolation frequency of multi-resist-
ant germs is high.
Etiologia bacterian i farmacorezistena germenilor izolai din hemoculturi

Man A.; Szekely Edit; Mare Anca; Toma Felicia
Disciplina de Microbiologie, Universitatea de Medicin i Farmacie Tg. Mure
Scop: Evaluarea etiologiei bacteriene a afeciunilor asociate cu bacteriemie din Spitalul Clinic
Judeean de Urgen Tg. Mure (SCJ) i evaluarea sensibilitii la antibiotice a germenilor izolai din
hemoculturi n anul 2008.
Material i metod: Au fost analizate 497 hemoculturi pozitive recoltate de la pacieni internai
n SCJ n perioada anului 2008. S-a analizat un singur izolat de la acelai pacient. Germenii izolai au
fost identificai i testai fa de antibiotice conform metodelor standard.
Rezultate: S-au identificat urmtorii germeni: stafilococi coagulazo-negativi (SCN) (50%), Sta-
phylococcus aureus (9%), E. coli (9%), Enterococcus spp. (7%), Acinetobacter spp. (6%), Pseudomo-
nas spp. (4%), alte specii (24%). n cazul SCN nu se cunoate ponderea izolatelor relevante, deoarece
n lipsa recoltrii seturilor duble de hemocultur nu s-au putut urmri criteriile diagnostice pentru im-
plicarea acestora n bacteriemii. n cazul tulpinilor de S. aureus, 55% au fost meticilino-rezistente
(MRSA). Tulpinile MRSA au fost identificate preponderent din seciile cu profil de terapie intensiv
(87%) i chirurgical (57%). Stafilococii i-au pstrat sensibilitatea fa de fenicoli, cotrimoxazol, gli-
copeptide i linezolid (100%), evideniindu-se o diferen semnificativ statistic ntre spectrul de

rezisten din seciile ATI i medicale (multirezisten n seciile ATI). Dintre enterobacterii predomin
E. coli (42%), Enterobacter spp. (19%), Klebsiella spp. (17%), altele (22%). Enterobacteriile prezint
rezisten la ampicilin (88%) i sensibilitate la carbapeneme (100%).
Concluzii: principalele bacterii izolate din hemoculturi sunt stafilococii i enterobacteriile. n
seciile cu profil de terapie intensiv i n care se efectueaz proceduri invazive sunt frecvente infeciile
cu stafilococi rezisteni la meticilin. Frecvena izolrii germenilor multirezisteni este crescut.
C43. Posterior mitral valve endocarditis accompaned by bacteraemia with

Granulicatella adiacens. A Case Report
Fldes Annamria1, Oprea Mihaela2, Bilca Doina-Veronica1, Farkas Lszlo Attila3,4,
Szkely Edit1,5, Stru Monica2
1. Dept. of Microbiology, Central Clinical Laboratory, Mure Districtual Emergency Hospital
Clinics; 2. Dept. of Molecular Microbiology, INCDMI Cantacuzino Bucharest; 3. Clinic of
Cardiovascular Rehabilitation Trgu-Mure; 4. Dept. of Medical Semiology, University of
Medicine and Pharmacy Trgu-Mure; 5. Dept. of Microbiology, University of Medicine and
Pharmacy Trgu-Mure
Granulicatella species, formerly known as nutritionally variant streptococci (NVS) are rarely im-
plicated in infective endocarditis (IE).
We report the case of a 65-year-old woman with ischemic cardiopathy and mitral valve insuffi-
ciency who developed endocarditis. She accused progressive dyspnea and two weeks prior to admis-
sion developed vesperal fever (3839 C) without chills and sweating.
Transoesophageal echocardiography revealed a vegetation established on the ventricular face of
posterior mitral valve. G. adiacens was recovered in pure culture from five sets of consecutive blood
cultures collected before antibiotic treatment. The phenotypic identification was based on morpholo-
gical characteristics, special cultural requirements (satellitism, capnophilia, anaerobic athmosphere)
and Vitek 2 Compact System. Molecular identification was performed by 16S rDNA gene sequence
analysis. The resulting sequence was compared to sequences from National Center for Biotechnology
Information (NCBI) on-line database and was confirmed as G. adiacens.
The patient was successfully treated intravenously with ceftriaxone and gentamycin.
The conventional diagnosis of a G. adiacens infection relies on the bacterian polymorphism in
Gram-stained smear, the discrepancy between direct smear result and the difficulty of growth using
standard techniques, in association with cultural dimorphism.
This case emphasises the importance of bacteriologic identification of G. adiacens and rapid ini-
tiation of an adequate antibiotherapy.
Acknowledgment: This work was supported by a CNCSIS grant Nr. 42-119-3/01.10.2008.
Keywords: Granulicatella adiacens, nutritionally variant streptococci (NVS), satellitism, infect-
ive endocarditis
Endocardit valvular mitral posterioar nsoit de bacteriemie cu

Granulicatella adiacens. Prezentare de caz
Fldes Annamria1, Oprea Mihaela2, Bilca Doina-Veronica1, Farkas Lszlo Attila3,4,
Szkely Edit1,5, Stru Monica2
1. Dept. de Microbiologie, Laboratorul Clinic Central, Spitalul Clinic Judeean de Urgen
Mure; 2. Laboratorul de Microbiologie Molecular, INCDMI Cantacuzino Bucureti; 3.
Clinica de Recuperare Cardiovascular Trgu-Mure; 4. Disciplina de Semiologie Medical,
UMF Trgu-Mure; 5. Disciplina de Microbiologie, UMF Trgu-Mure
Speciile de Granulicatella cunoscute i sub denumirea de streptococi deficieni nutritiv sunt
foarte rar implicate n etiologia endocarditei infecioase (EI).
Redm cazul pacientei F.V. de 65 ani care pe fondul unei cardiopatii ischemice dilatative cu in-
suficien mitral a dezvoltat endocardit bacterian. Pacienta a acuzat agravarea progresiv a dispneei,
iar cu dou sptmni anterior momentului internrii a prezentat ascensiuni febrile vesperale (38 39
C) neacompaniate de frisoane i transpiraii.
Ecocardiografia transesofagian a evideniat o vegetaie pe faa ventricular a valvei mitrale pos-
terioare. Din cinci seturi succesive de hemoculturi recoltate naintea instituirii tratamentului antibiotic
s-a izolat n cultur pur G. adiacens. Identificarea fenotipic s-a realizat pe baza caracteristicilor mor-
fologice macro- i microscopice, a condiiilor speciale de cultivare (satelitism, capnofilie, anaerobioz)
i n mod automat cu Vitek 2 Compact System. Identificarea molecular s-a realizat prin secvenierea
genei ADNr 16S. Secvena obinut a fost comparat cu secvene existente n baza de date on-line a
National Center for Biotechnology Information (NCBI), confirmndu-se apartenena la specia G. adi-
acens.
Pacienta a evoluat favorabil sub tratament intravenos cu ceftriaxon i gentamicin.
n diagnosticarea convenional a unei infecii cu G. adiacens trebuie inut cont de: polimorfis-
mul bacterian din frotiul colorat Gram, discrepana ntre rezultatul frotiului direct i dificultatea obin-
erii unei culturi bacteriene prin procedee uzuale, n asociere cu dimorfismul cultural.
Cazul prezentat subliniaz importana identificrii bacteriologice a G. adiacens coroborat cu in-
stituirea precoce a unei antibioterapii adecvate.
Prezentul studiu s-a realizat n cadrul grantului CNCSIS Parteneriate n Domeniile Prioritare
Nr. 42-119-3/01.10.2008.
Cuvinte cheie: Granulicatella adiacens, streptococi deficieni nutritiv, satelitism, endocardit in-
fecioas
C44. Implication of Clostridium difficile in the aetiology of hospital acquired

diarrhoea
Mare Anca1; Szekely Edit1; Man A.1; Toma Felicia1; Bilc Doina2
1. Microbiology Departement, University of Medicine and Pharmacy Tg.Mure;
2. Department of Microbiology, Central Laboratory, Emergency Clinical Hospital Tg. Mure
Purpose: The evaluation of Clostridium difficile (C. difficile) involvement in the aetiology of
hospital acquired diarrhoea.
Material and method: During 01.11.2008 29.02.2009, in the Microbiology Laboratory from
Mure Emergency County Hospital, there were analysed 170 samples of stools. These samples were
processed according to the laboratorys protocol for isolation of pathogenic bacteria from stool (this
protocol does not include routine testing for C. difficile infection). From the 170 samples of stools,
there were selected 22 diarrhoeic samples which were suggestive for C. difficile associated disease.
These samples were analysed on MiniVidas system for the presence of C. difficile toxins A and B, at
the Department of Microbiology within University of Medicine and Pharmacy Trgu-Mure. The posit-
ive samples were cultivated on C. difficile agar and incubated in anaerobic atmosphere. The identifica-
tion of C. difficile was based on the microscopic morphological characters, the colonies aspect and the
latex agglutination test.
Results: After processing the 170 samples according to the laboratorys protocol, there were
identified 3 positive samples (one pathogenic strain of Escherichia coli, one of Salmonella spp. and
one of Shigella boydii), representing 1.76%. The low percentage of positive samples can be explained
by the hospitals profile, which does not include the Department of Infectious Diseases. From the 22
diarrhoeic stools that were selected, 5 were positive for C. difficile (22.7%).
Conclusions: The detection of C. difficile as an aetiological agent in hospital acquired diarrhoea
sustains the importance of routine testing for this species. The rigorous selection of the stool samples
has an important role in equilibrating the costs and the efficiency for this diagnostic.
Implicarea Clostridium difficile n etiologia diareei intraspitaliceti

Mare Anca1; Szekely Edit1; Man A.1; Toma Felicia1; Bilc Doina2
1. Disciplina de Microbiologie, Universitatea de Medicin i Farmacie Tg.Mure;
2. Laboratorul de Analize Medicale Central, Departamentul de Microbiologie, Spitalul Clinic
Judeean de Urgen Tg. Mure
Scop: Evaluarea implicrii infeciei cauzate de Clostridium difficile n etiologia diareii acute in-
traspitaliceti.
Material i metod: n perioada 01.11.2008 29.02.2009, n cadrul Laboratorului de Microbio-
logie al Spitalului Clinic Judeean de Urgen Mure, s-au analizat 170 probe de materii fecale. Acestea
au fost prelucrate conform protocolului de coprocultur al laboratorului (acesta nu include testarea de
rutin pentru C. difficile). Din cele 170 de probe de materii fecale, au fost selectate 22 scaune diareice
care corespundeau criteriilor ce sugereaz implicarea etiologic a C. difficile. Aceste probe au fost an-
alizate pentru prezena toxinelor A i B produse de C. difficile cu ajutorul sistemului MiniVidas, la Dis-
ciplina de Microbiologie din cadrul Universitii de Medicin i Farmacie Trgu Mure. Probele pozit-
ive pentru toxine au fost cultivate n anaerobioz pe mediul C. difficile agar. Identificarea s-a fcut pe
baza caracterelor morfotinctoriale, a caracterelor de cultur i a latexaglutinrii.
Rezultate: n urma prelucrrii celor 170 de probe prin protocolul coproculturii s-au identificat 3
probe pozitive (o tulpin patogen de Escherichia coli, una de Salmonella spp. i una de Shigella boy-
dii), reprezentnd un procent de 1,76%. Procentul sczut al pozitivrii coproculturilor poate fi explicat
prin profilul spitalului, care nu include secia de boli infecioase. Din cele 22 scaune diareice selectate,
5 au fost pozitive pentru C. difficile (22,7%).
Concluzii: Detectarea implicrii C. difficile n etiologia diareii intraspitaliceti susine import-
ana diagnosticrii de rutin a acestei specii. Un rol important n echilibrarea raportului cost /eficien
al acestui diagnostic l are selectarea riguroas a probelor care se testeaz.
C45. The etiology profile and the antibiotic susceptibility pattern of the
urinary tract infections in hospitalized and community patients
Nicolescu .1, ucra R.1, Vitan A.1, Anghel G.1, Gherase C.2, Tbrc N.2
1. Medical Analysis Laboratory Almina Trading S.R.L., Trgovite; 2. Clinical Laboratory of
the District Emergency Hospital, Trgovite
Objective: The purpose of this study was to determine and compare the bacterial etiology and
the sensitivity to antibiotics of the urinary tract infections detected in hospitalized patients and in out-
patients.
Materials and methods: We have included in the study 941 bacterial strains isolated from pa-
tients hospitalized in the District Emergency Hospital - Trgovite, and 281 strains isolated from com-
munity patients investigated at the Medical Analysis Laboratory Almina Trading s.r.l. - Trgovite.
The isolates were obtained from the urinary specimens collected between January 1 and December 31,
2008. The strains obtained in the Medical Analysis Laboratory Almina were isolated, identified and
tested for the antibiotic susceptibility using the conventional methods. The methods used in the Clinical
Laboratory of the District Hospital were combined, conventional and automated (the microbiology ana-
lyzer: Vitek - Biomerieux).
Results: The most frequently isolated specie was in both cases Escherichia coli, with an incid-
ence of 69% in hospitalized patients and 73% in outpatients, followed at distance by Klebsiella spp. -
20% in hospitalized patients and 13% in non-hospitalized ones. The antibiotic sensitivity pattern was
also similar, the closest results being obtained at Ceftazidime (92% in hospitalized patients and 88% in
outpatients), Gentamycin (95% versus 90%), Norfloxacin ((88% versus 93%), and Ciprofloxacin (82%
versus 80%).
Conclusion: Escherichia coli is still the most frequent bacterial agent responsible for urinary
tract infections, in both hospitalized and community patients. The incidence of the infection with E.
coli and its antibiotic susceptibility were very similar in the two groups of patients involved in this
study.
Profilul etiologic i spectrul sensibilitii la antibiotice al infeciilor urinare

la pacienii spitalizai i la cei investigai n ambulator
Nicolescu .1, ucra R.1, Vitan A.1, Anghel G.1, Gherase C2., Tbrc N.2
1. Laboratorul de Analize Medicale al S.C. Almina Trading S.R.L. - Trgovite;
2. Laboratorul Clinic al Spitalului Judeean de Urgen - Trgovite
Obiectiv: Studiul de fa a fost realizat cu scopul de a determina i compara profilul etiologic i
sensibilitatea la antibiotice n infeciile urinare depistate la pacienii spitalizai i la cei investigai n
ambulator.
Materiale i metode: Au fost incluse n studiu 941 de tulpini bacteriene izolate de la pacienii
internai n Spitalul Clinic Judeean Trgovite, i 281 de tulpini izolate de la pacienii investigai n
Laboratorul de Analize Medicale Almina, Trgovite. Tulpinile au fost obinute din uroculturile re-
coltate n perioada 1 ianuarie - 31 decembrie 2008.
Metodele de lucru folosite la izolarea, identificarea i testarea sensibilitii la antibiotice a
tulpinilor bacteriene au fost cele convenionale n Laboratorul Almina, n timp ce n Laboratorul Clinic
al Spitalului Judeean s-au folosit metode combinate, convenionale i automate (analizor de bacteriolo-
gie Vitek - Biomerieux).
Rezultate: Specia microbian izolat cel mai frecvent a fost n ambele grupuri de studiu Es-
cherichia coli, avnd o inciden de 69% la bolnavii internai i de 73% la cei investigai n ambulator,
urmat la distan de Klebsiella spp. - 20% la pacienii spitalizai i 13% la cei din ambulator. i anal-
iza spectrului sensibilitii la antibiotice a relevat similariti, rezultatele cele mai apropiate nregis-
trndu-se la Ceftazidim (92% la pacienii spitalizai i 88% la cei investigai n laborator), Gentamicina
(95%, respectiv 90%), Norfloxacin (88%, respectiv 93%) i Ciprofloxacin (82 %, respectiv 80%).
Concluzie: Escherichia coli este n continuare specia bacterian cea mai frecvent implicat n
etiologia infeciilor urinare, att n cazul pacienilor spitalizai ct i la cei investigai n ambulator.
Incidena infeciei urinare cu E. coli i sensibilitatea sa la antibiotice au nregistrat valori foarte
apropiate n ambele eantioane de pacieni inclui n studiu.
Molecular Biology
R47. HCV RNA monitoring in patients undergoing antiviral therapy. Is it a
correlation between the results obtained between Roche Amplicor and
Roche TaqMan methods?
Neuman Manuela
In Vitro Drug Safety and BioTechnology Laboratory, Department of Pharmacology, Faculty
of Medicine, University of Toronto, Toronto, ON, Canada
Background: There has been considerable progress in antiviral therapy for hepatitis C since
1989 when six months of interferon monotherapy was shown first to be effective in normalizing serum
alanine aminotransferase (ALT) levels in a proportion of patients with chronic non-A, non-B hepatitis,
known as viral hepatitis C (HCV). However, once the hepatitis C virus was identified, it became appar-
ent that only a small proportion of these patients cleared virus after treatment. Extending the course of
treatment to a year doubled the rate of viral clearance. More impressively, the addition of the oral nuc-
leoside ribavirin to the interferon regimen dramatically increased the durable viral clearance rate com-
pared to interferon alone. However, the initial studies of the combination of interferon and ribavirin
found that viral genotype had a significant impact on interferon sensitivity and treatment response. In-
deed, in patients infected with genotype 2 or 3 the sustained viral response (SVR) was the same wheth-
er they received 6 or 12 months of treatment. Thereafter, the duration of therapy was modified accord-
ing to the genotype of the infecting virus. This tailoring of therapy continued as pegylation of the par-
ent interferon drug extended its half-life, allowing greater exposure to the drug despite less frequent
dosing. When combined with ribavirin, pegylated interferons increased the SVR to more than 50%.
Treatment was further customized with the concept of stopping rules that modified treatment based the
viral response, or rather the lack of response, during the initial weeks of treatment. Failure to reduce
the HCV RNA level by at least 2 logs after the first 3 months of treatment (early viral response; EVR)
predicted treatment failure and justified discontinuation of therapy.
Therefore to distinguish between the different methods to determine HCV-RNA and their sensit-
ivity is essential in monitoring the antiviral therapies.
C48. CD4 cell count and viral load evolution in patients with immunological
and virological discordant response to HAART therapy
Fodor Mrta Andrea1, Dobreanu Minodora1, Sabu Monica2, Chiriac Carmen3, Tilea
Brandusa3, Kezdi Iringo3, Georgescu Anca3, Urcan Rodica3, Garbovan Cristina3, Incze
Andrea3, Moldovan Andreea3
1. Dept. of Clinical Biochemistry Molecular Biology Laboratory, University of Medicine
and Pharmacy, Trgu Mure, 2. University of Medicine and Pharmacy, Trgu Mure, Dept.
Epidemiology, 3. Infectious Diseases Clinic, Trgu Mure
The goals of antiretroviral therapy in HIV infection are: reduction of plasma HIV - RNA levels,
immune reconstitution (regarded as the increase of the number of CD4 cells) and a favorable clinical
outcome.
The aim of the study was to compare the evolution of CD4, CD8 cell count, CD4/CD8 cell ratio
and the viral load in immunologically (I-V+) and virologically (I+V-) discordant responder groups,
with those seen in complete responder (I+V+) and non responder (I-V-) groups.
Material: The study was performed in Tg. Mures Infectious Diseases Clinic, on 144 HIV infec-
ted patients, 7 - 42 years old, receiving antiretroviral therapy.
Method: Patients were classified in four groups, according to their CD4 and HIV RNA response
to antiretroviral treatment: responders (I+V+), nonresponders (I-V-), immunologically discordant re-
sponders (I-V+) and virologically discordant responders (I-V+). We compared the variation of CD4,
CD8 cell count, CD4/CD8 cell ratio and the viral load in the four groups, using the t-student test .
Results: We found statistically significant differences between the initial and final CD4 cell
count within the groups, between the final CD8 cell count in I-V- and I+V- groups and the CD4/CD8
cell ratio in I-V- and I+V+ groups. No statistically significant difference was found between the initial
values of viral load.
Conclusions: The immunologically discordant response (I-V+) seems to be associated with ini-
tial elevated CD4 cell count. The virological discordant response (I+V-) seems to be associated with
the initial low CD4 cell and final elevated CD8 cell. The complete nonresponse (I-V-) seems to be as-
sociated with initial elevated CD4 cell, final low CD8 cell count and low CD4/CD8 cell ratio. The
complete response (I+V+) seems to be associated with the initial low CD4 cell and final elevated CD4/
CD8 cell ratio.
Aspecte ale evoluiei numrului de limfocite CD4 i a ncrcturii virale la

pacieni cu infecie HIV/SIDA sub tratament HAART
Fodor Mrta Andrea1, Dobreanu Minodora1, Sabu Monica2, Chiriac Carmen3, Tilea
Brandusa3, Kezdi Iringo3, Georgescu Anca3, Urcan Rodica3, Garbovan Cristina3, Incze
Andrea3, Moldovan Andreea3
1. UMF Tg. Mure, Disc. Biochimie clinic Laboratorul de Biologie Molecular; 2. UMF
Tg. Mure, Disc. de Epidemiologie; 3. Clinica de Boli Infecioase, Trgu Mure
Scopul administrrii tratamentului antiretroviral n infecia cu HIV este reducerea nivelelor plas-
matice ale ARN HIV plasmatic, reconstrucia imun (creterea numrului limfocitelor CD4) i
obinerea unei evoluii clinice favorabile.
Scop: Compararea loturilor cu rspuns discordant virusologic (I+V-) i imunologic (I-V+) din
punct de vedere al evoluiei numrului de limfocite CD4, CD8 i a raportului CD4/CD8, cu loturile cu
rspuns optim la tratament (I+V+), respectiv eec terapeutic (I-V-).
Material: am prelucrat datele a 144 de pacieni cu infecie HIV/SIDA aflai n evidena
Centrului Regional de Monitorizare al Infeciei HIV/SIDA Mure, aflai sub tratament antiretoviral.
Metod: Am mprit pacienii n urmtoarele patru loturi: lotul cu rspuns discordant imunolo-
gic (I-V+), rspuns discordant virusologic (I+V-), lotul cu eec terapeutic (I-V-) i lotul cu rspuns op-
tim la tratament (I+V+). Am urmrit evoluia numrului de limfocite CD4, CD8 i a ncrcturii virale
n determinate la nceputul, respectiv la sfritul perioadei studiate, comparnd prin testul t-student,
valorile obinute la cele patru loturi.
Rezultate: am gsit diferen semnificativ statistic ntre numrul iniial i final al limfocitelor
CD4 la cele patru loturi, numrul final de limfocite CD8 la loturile I-V- i I+V- i variaia raportului
CD4/CD8 la loturile I-V- i I+V+. Nu am gsit diferen semnificativ statistic ntre valoarea ncr-
cturii virale iniiale la cele patru loturi.
Concluzii: Rspunsul discordant imunologic (I-V+) se asociaz cu CD4 iniial crescut. Rspun-
sul discordant virusologic (I+V-) se asociaz cu CD4 iniial relativ sczut, CD8 final crescut. Eecul
terapeutic se asociaz cu CD4 iniial relativ crescut, CD8 final sczut i raport CD4/CD8 sczut.
Rspunsul optim la tratament se asociaz cu CD4 iniial relativ sczut i raport CD4/CD8 crescut.
Clinical Chemistry 1
R51. Biological and functional investigations of the renin-angiotensin-
aldosterone system in hypertension
Bricca Giampiero
Exploration Fonctionnelle Endocrinienne et Mtabolique, Centre de Biologie Nord, Hpital
de la Croix-Rousse; INSERM ERI22, EA4173 : Agressions Vasculaires Rponses
Tissulaires, Universit Claude Bernard Lyon 1; Universit de Lyon, France
The biological investigations in hypertension aim at detecting end-organ damage and identifying
curable causes of hypertension or at least to unravel physiopathological mechanisms underlying specif-
ic therapeutic approaches. Aside from catecholamines and phaeochromocytoma, the biological and
functional analysis of the renin angiotensin aldosterone system are required to identify the most com-
mon as well as the rarest forms of hypertension. In view of the very high reactivity to a large variety of
environmental and genetic factors, the interpretation of the biological data and the strategy of the
choice of functional tests, through activation or inhibition at the different levels of regulation, should
follow strict normalization and prospective evaluation. A set of simple rules for the measurement and
the interpretation will be discussed.
R53. Emerging Risk Markers and Novel Targets for

Cardiovascular Prevention
Blaton V.
KU-Leuven and Department Clinical Chemistry, Brugge, Belgium
Atherosclerosis, the major risk for coronary heart disease events, is no longer considered as a
lipid disorder. It is a process of dynamic interactions, where Cytokines , Cell Adhesion Molecules
and Acute Phase proteins (hs-CRP and SAA) are key players in the CV-events.
Multiple risk factors management is a critical area in cardiovascular prevention and therapy.
Aim is to offer integrated view of the new approaches now prevailing which include combined control
of lipid disorders, hypertension, thrombosis, diabetes and the increasing use of polytherapy to reduce
global cardiovascular risk.
The recent findings on inflammatory processes involved in atherosclerosis development provide
important links between risk factors and the mechanisms of atherosclerosis. Thus research interest has
increasingly focused on inflammatory biomarkers as a means of predicting the risk of future clinical
events. Indeed elevated plasma levels of soluble intercellular adhesion molecules or C-reactive protein
(hs CRP and SAA) has been show to represent inflammatory markers of future cardiovascular risk. The
acute phase response (APR) can impair the anti-inflammatory functions of high density lipoproteins
(HDL particles). HDL-C is highly inversely related to the degree of stenosis, directly to the acute phase
proteins SAA and hs-CRP and inversely to the pro-inflammatory cytokines, which can be followed by
the ratio of IL 6/ IL 10. The clinical and preventive aspects of hs-CRP have to be considered.
Epidemiological studies have identified low-density lipoproteins (LDL) and high-density lipo-
proteins (HDL) as independent risk factors that modulate cardiovascular disease (CVD) risk. Low
HDL is often present in high risk patients with CVD. Other lines of evidence suggest that raising HDL
would reduce the risk of CV-events. Infusion of apoA-I/phospholipids complexes was associated with
regression of arterial lesions, over expression of human apoA-I in transgenic animals protects against
diet induced and genetically determined atherosclerosis. These combined results support the concept
that raising HDL may represent a therapeutically target for prevention of CV events. Thus, an under-
standing of
HDL metabolism is critical to explaining why increased HDL is protective. Understanding of
how HDL protects against CVD is still incomplete, there is evidence that supports at least three major
atheroprotective mechanisms of HDL. HDL mediated efflux of cholesterol from cholesterol-loaded
macrophages is a well established anti-atherogenic function of HDL
Low-density lipoproteins (LDLs) are susceptible to structural modifications by oxidation, partic-
ularly the small dense LDL particles. Oxidized LDL (oxLDL) formation in the subendothelial space of
the arterial wall is a key initiating step in atherosclerosis because it contributes to foam cell generation,
endothelial dysfunction, and inflammatory processes. In the last decade, immunoassays were de-
veloped using monoclonal antibodies against oxidation-dependent epitopes of LDL which made it pos-
sible to directly measure oxLDL in the circulation. Increased circulating oxLDL concentrations have
been related to cardiovascular disease in some studies, although not always independently after adjust-
ment of classical lipid markers. The Asklepios Study, investigating 2524 healthy middle-aged subjects,
showed that circulating oxLDL is affected by many biological and lifestyle factors, as well as (general-
ized) subclinical atherosclerosis.
Multidisciplinary efforts can effectively alter patient behaviour and modify risk factors. In order
to achieve these objectives, there is an urgent need for updating and harmonizing laboratory reports of
lipid analyses in concordance with the European guidelines.
R54. Inflammation and atherosclerotic plaque vulnerability

Dobreanu Minodora
Department of Clinical Biochemistry, University of Medicine and Pharmacy Tirgu Mures
Despite a lot of progress, atherosclerotic cardiovascular disease still represents killer number one
in the western world and is starting to have increased impact in developing countries. Most of the car-
diovascular events that are caused by atherosclerosis, such as acute myocardial infarction or stroke, are
the result of a transition of so-called stable atherosclerotic plaques to vulnerable plaques. The critical
role of plaque composition rather than plaque size or stenosis severity is important for plaque vulnerab-
ility. The phenotype of the plaque predisposed to rupture has several distinctive features: a large lipid
core composed of oxidized lipids, free and esterified cholesterol, thin fibrous cap, many inflammatory
cells (monocyte derived macrophages, activated T cells, dendritic cells and mast cells), fewer intimal
smooth muscle cells and increased neovascularity. The lipid core is intense thrombogenic due to direct
platelet activation and impregnation with active tissue factor.
Current clinical risk profiling algorithms, such as the Framingham and Procam risk scores, have
predictive value in the assessment of the 10 year risk. However, the challenge remains to identify those
patients with a very high risk of suffering from myocardial infarction in the coming months. The trans-
ition of stable atherosclerotic plaques to vulnerable plaques is typically heralded by inflammation. The
ability to identify atherosclerotic plaques that are prone to rupture, may provide a major step forward in
the recognition of patients that have a high risk of developing acute myocardial infarction. Apoptosis is
linked to all of these features of plaque vulnerability, and may, therefore, provide uniquely useful tar-
gets for the identification of plaque vulnerability. Molecular imaging may help identify plaque inflam-
mation and apoptosis of inflammatory cells, which are obligatory components of the plaque instability.
Development of apoptosis imaging technologies may allow in the near future to identify patients with
critical cardiovascular risks, to treat myocardial infarction in its imminent, instead of its evident phase.
Plaque stabilization represents a novel challenge in atherosclerosis management and is con-
sidered to be more important than regression.
Inflamaia i placa de aterom instabil

Dobreanu Minodora
Disciplina de Biochimie Clinic, Universitatea de Medicin i Farmacie Tirgu Mures
n ciuda a numeroase progrese, boala cardiovascular aterosclerotic reprezint principala cauz
de deces n rile vestice i ncepe s aib un impact tot mai mare n rile n curs de dezvoltare. Cele
mai multe evenimente cardiovasculare cu substrat aterosclerotic (cum ar fi infarctul de miocard sau ac-
cidentul vascular cerebral) sunt rezultatul tranziiei plcilor stabile spre starea de plci vulnerabile. Un
rol critic n vulnerabilitatea plcii de aterom l are mai degrab compozia acesteia, dect dimensiunea
sau severitatea stenozei. Fenotipul plcii predispuse la ruptur se caracterizeaz prin: miez lipidic
abundent alctuit din lipide oxidate, colesterol liber i esterificat, capion fibros subire, numeroase ce-
lule inflamatorii (macrofage, limfocite T activate, celule dendritice i mastocite), puine celule muscu-
lare netede i o neovasculariie bine reprezentat. Miezul lipidic este intens trombogenic, datorit efec-
tului activator direct asupra plachetelor, precum i impregnrii cu factor tisular activ.
n calcularea profilului de risc clinic se utilizeaz actualmente scorurile de risc Framingham i
Procam, care ofer valoarea predictiv pe 10 ani. Provocarea rmne ns aceea de a identifica acei pa-
cieni cu un risc foarte crescut de a face un infarct miocardic acut n lunile urmtoare. Tranziia plcii
de aterom din stare stabil n aceea de plac vulnerabil este cauzat de inflamaie. Capacitatea de a
identifica acele plci n pericol de a se rupe, ar putea fi un pas nainte n recunoaterea pacienilor cu
risc crescut de a dezvolta infarct miocardic acut. Evidenierea apoptozei celulelor inflamatorii din placa
de aterom ar putea fi modul de identificare a plcilor vulnerabile. n viitorul apropiat, tehnologiile ima-
gistice moleculare ar putea evidenia inflamaia i apoptoza celulelor inflamatorii (componente obligat-
orii ale plcii instabile) chiar la nivel coronar, permind identificarea pacienilor cu risc cardiovascular
critic, tratarea infarctului de miocard pe cale s se produc i nu pe acela deja constituit.
Stabilizarea plcilor aterosclerotice reprezint o provocare n abordarea terapeutic a acestei
patologii, fiind considerat mai important dect regresia.
R55. Lipid-driven inflammatory monocytes accelerate the development of

transplant arteriosclerosis
Schiopu Alexandru, Nadig Satish, Wood Kathryn J.
Transplantation Research Immunology Group, Nuffield Department of Surgery, John
Radcliffe Hospital, Oxford University, United Kingdom
Introduction. Transplant arteriosclerosis (TA), defined as diffuse intimal hyperplasia in the ar-
teries of transplanted organs, is one of the the main pathological processes leading to chronic allograft
rejection. Several studies have identified plasma cholesterol as the most important non-immunologic
risk factor for chronic rejection in heart and kidney recipients, but the underlying mechanisms are still
unknown.
Materials and methods. We have studied the influence of lipid environment on the develop-
ment of transplant arteriosclerosis in a fully mismatched arterial interposition graft model. CBA (H2 k)
arterial grafts were transplanted into the abdominal aorta of hyperlipidemic C57Bl/6 (H2b) ApoE-/- mice
kept on normal diet or on a high-fat diet. Normolipidemic wild-type C57Bl/6 recipients served as con-
trols. The arterial grafts were harvested 21 days after transplantation and we assessed the extent of
transplant arteriosclerosis, cellular and lipid infiltration into the neointima, as well as plasma cholester-
ol levels. Graft recruitment of inflammatory GRhi and steady-state GR1lo monocytes was tracked using
a fluorescent bead labelling technique.
Results. TA development was accelerated almost 3 times in CBA vessels transplanted into the
hyperlipidemic ApoE-/- mice on a high fat diet compared to the wild-type recipients (59.613% versus
23.210.5%, P<0.01). The Oil Red O lipid staining revealed an intense diffuse lipid infiltration
throughout the neointima in the ApoE-/- recipients, whereas the lesions developed in wild-type C57Bl/6
mice presented only minimal lipid content. We found an intense macrophage foam cell staining in the
arteries transplanted into the hyperlipidemic mice, with no significant increase in the presence of T
cells into the grafts. There was a direct correlation between macrophage infiltration, plasma cholesterol
levels and lesion extent. The inflammatory GRhi monocytes were recruited to the lesions to a much
higher extent than their GR1lo counterparts in both mouse strains. The increase in plasma cholesterol
levels preferentially increased GRhi monocytes recruitment.
Conclusion. Our study further highlights the importance of post-transplant lipid management in
all solid organ recipients. We show that lipids exacerbate the development of transplant arteriosclerosis
in a dose-dependent manner and heavily infiltrate the newly formed neointimal layer. Our study identi-
fies the accelerated recruitment of inflammatory GRhi monocytes as the main link between plasma cho-
lesterol and the development of chronic vascular rejection. Future dissection of these mechanisms
might offer additional therapeutic targets for improvement of long-term allograft survival.
Lipidele plasmatice accelereaza dezvoltarea arteriosclerozei de transplant

prin intermediul recrutarii de monocite inflamatorii in peretele arterial
Schiopu Alexandru, Nadig Satish, Wood Kathryn J.
Transplantation Research Immunology Group, Nuffield Department of Surgery, John
Radcliffe Hospital, Oxford University, United Kingdom
Introducere. Arterioscleroza de transplant, definita ca o hiperplazie intimala difuza dezvoltata in
arterele grafturilor solide post-transplant, este unul dintre cele mai importante procese patologice re-
sponsabile pentru inducerea rejetului cronic. Mai multe studii au identificat nivelul colesterolului plas-
matic ca fiind principalul factor de risc asociat cu rejetul cronic in transplantul de inima si rinichi dar
mecanismele patologice sunt in momentul de fata necunoscute.
Material si metoda. Am studiat influenta mediului lipidic asupra dezvoltarii arteriosclerozei de
transplant intr-un model de transpozitie arteriala complet alogeneic. Grafturi arteriale preluate de la
soareci CBA (cu antigene de histocompatibilitate H2k) au fost transplantate in aorta abdominala a mai
multor grupuri de soareci hiperlipidemici C57Bl/6 (H2b) ApoE-/- tinuti pe dieta normala sau dieta
bogata in lipide. Am folosit ca si grup de control soareci normolipidemici C57Bl/6 wild-type.
Grafturile arteriale au fost colectate 21 de zile mai tarziu. Am masurat in aceste grafturi atat nivelul de
arterioscleroza cat si infiltratul celular si lipidic din neointima si nivelul de cholesterol plasmatic. Util-
izand o tehnica de marcare cu particule de latex flourescente am urmarit de asemenea recrutarea la
nivelul graftului a celor 2 populatii de monocite, inflamatorii (GR1hi) si patrulante (GR1lo).
Rezultate. Dezvoltarea arteriosclerozei de transplant a fost accelerata de aproape 3 ori in
grafturile transplantate in recipientii hiperlipidemici in comparatie cu cei normolipidemici (59.613%
fata de 23.210.5%, P<0.01). Colorarea lipidelor intra-tisulare cu Oil Red O a aratat o infiltrare intensa
in neointima vaselor transplantate in recipienti ApoE-/- comparativ cu infiltrare minima in recipientii
wild-type. In arterele transplantate in recipientii hiperlipidemici a fost gasita existenta unui infiltrat
extins de celule spumoase derivate din macrofage, dar recrutarea de celule T nu a fost crescuta. De ase-
menea am evidentiat existenta unei corelatii directe intre intensitatea infiltratului macrofagic, marimea
leziunilor si nivelul de colesterol plasmatic. Monocitele inflamatorii GRhi au fost recrutate in interiorul
grafturilor cu o rata mult mai mare decat monocitele GR1lo in ambele grupuri de recipienti. Cresterea
nivelului colesterolului plasmatic a accelerat in mod preferential recrutarea de monocite GRhi.
Concluzii. Studiul nostru evidentiaza importanta tratamentului hiperlipidemiei in toti recipientii
de organe solide. Am aratat ca lipidele infiltreaza stratul neointimal format si exacerbeaza dezvoltarea
arteriosclerozei de transplant intr-o maniera dependenta de nivelul plasmatic. Rezultatele acestui studiu
sugereaza ca recrutarea accelerata de monocite inflamatorii constituie veriga de legatura intre nivelul
colesterolului plasmatic si dezvoltarea rejetului cronic. Clarificarea in detaliu a acestor mecanisme ar
putea oferi noi tinte terapeutice in vederea prelungirii supravietuirii pe termen lung a grafturilor solide.
Clinical Chemistry 2
R57. HbA1c: A brief overview
Higgins Trefor
Dept.of Clinical Chemistry, DynaLifeDx, Edmonton, Canada
HbA1c has become the test of choice for monitoring glycemic control in individuals with dia-
betes mellitus. Recommendations for analytical performance, reporting and clinical usage have been
published including the setting of a HbA1c <7% as a therapeutic target. It is well established that
HbA1c values are influenced by a number of variables including red cell survival and the presence of
hemoglobin variants. Recent work demonstrates that HbA1c values are influenced by age, race, season,
temperature change and smoking. HbA1c has recently been suggested as a screen for diabetes mellitus.
In this presentation the effect of variables on HbA1c values, the difference in HbA1c reporting recom-
mendations and the use of HbA1c as a screening test for diabetes mellitus will be described.
R58. High Performance Liquid Chromatography (HPLC) for Hemoglobin

A1c determination in human whole blood
Beaulieu Yves
Bio-Rad Laboratories (Canada) Ltd, Clinical Diagnostics Group
Diabetes is a self-managed disease. It is rampant and escalating into a healthcare crisis. Glycated
hemoglobin is an indicator of the metabolic control of the diabetic, the patient's long-term compliance
to treatment.
Bio-Rad is at the forefront of diabetes care helping clinicians monitor A1c in their patients. The
speaker will discuss in layman's terms the analysis of A1c by High Performance Liquid Chromato-
graphy, a technique that is widely used. There will be discussed some of the advantages of HPLC over
immunological methods, the fact that it also provides additional information about hemoglobinopath-
ies. The presentation will also cover Bio-Rad's line of instruments that can fulfill the needs of hospitals
and clinics of any size.
C59. Identification of enhanced risk-groups regarding complications in

diabetic patients
Nemes-Nagy Enik1, Al-Aissa Zahra2, Kirizs Rbert2, Dobreanu Minodora3, Higgins
Trefor4
1. Medical Biochemistry Dept, University of Medicine and Pharmacy, Trgu Mure; 2.
University of Medicine and Pharmacy, Trgu Mure, medical student; 3. Dept. of Clinical
Biochemistry and Laboratory, University of Medicine and Pharmacy, Trgu Mure; 4.
DynaLifeDx (formerly Dynacare-Kasper Medical Laboratories), Edmonton, Canada
Introduction: Diabetes mellitus is a chronic disease of the entire organism. Glycated
haemoglobin (HbA1c) is an important parameter used to evaluate the efficacy of the treatment. The
aim of the study is to evaluate carbohydrate metabolic balance in different groups of type 1 and type 2
diabetic patients. Materials and methods: HbA1c values were determined at the Central Laboratory of
the County Emergency Clinical Hospital in TrguMure using the Variant Hemoglobin Testing System
(Bio-Rad) analyzer (n = 3520). Diabetic patients were selected in groups depending on their age,
gender, environment, body weight, type of the disease and modality of treatment. Results: In type 1
diabetic patients (especially in teenagers) optimal metabolic balance is harder to achieve compared
with type 2 diabetic adults (p=0,0008). In infants under 10 of age HbA1c average value is significantly
lower compared with elder children (p<0,005). 26% of diabetic adults suffer from LADA (latent
autoimmune diabetes in adults). Patients from urban environment present significantly smaller HbA1c
values compared with rural patients (p<0,05). Younger obese diabetics have significantly higher
HbA1c values compared with elder obese diabetic patients (p<0,05). We didnt notice significant
differences between HbA1c values in type 2 diabetic patients treated with oral antidiabetic drugs
compared with those treated with insulin (p=0,31). Conclusions: Based on the results obtained we
identified some groups of diabetic patients which require special attention to prevent complications of
the disease (type 1 diabetic teenagers, diabetics from rural environment, young obese patients).
Appropriate medical education, healthy lifestyle, determination of glycaemic profile every day and
consequently adjusting insulin doses, together with measurement of HbA1c values 3-4 times every
year could have a benefic influence on carbohydrate metabolic balance in these groups of diabetic
patients presenting increased HbA1c values.
Identificarea unor subgrupe cu risc ridicat de complicaii n cadrul

pacienilor diabetici
Nemes-Nagy Enik1, Al-Aissa Zahra2, Kirizs Rbert2, Dobreanu Minodora3, Higgins
Trefor4
1. Disciplina de Biochimie Medical, UMF Trgu Mure; 2. UMF Trgu Mure, student MG;
3. Disciplina de Biochimie Clinic i Laborator, UMF Trgu Mure; 4. DynaLifeDx (anterior
Dynacare-Kasper Medical Laboratories), Edmonton, Canada
Introducere: Diabetul zaharat este o boal a ntregului organism, cu evoluie cronic.
Hemoglobina glicat (HbA1c) este un parametru de baz pentru evaluarea eficacitii tratamentului.
Scopul lucrrii este urmrirea echilibrului metabolic glucidic la diferite grupuri din cadrul pacienilor
cu diabet zaharat de tip 1 i 2.Material i metod: Valorile de HbA1c au fost determinate n cadrul
Laboratorului Central al Spitalului Clinic Judeean de Urgen Trgu Mure cu analizorul Variant
Hemoglobin Testing System (Bio-Rad). Diabeticii (n = 3520) au fost repartizai n subgrupe n funcie
de vrst, sex, mediu de provenien, mas corporal, tipul bolii i modalitatea de tratament. Rezultate:
La pacienii cu diabet zaharat de tip 1 (n special la adolesceni) este mai dificil de realizat echilibrul
metabolic optim comparativ cu adulii cu diabet de tip 2 (p=0,0008). La copiii sub 10 ani media HbA1c
este semnificativ mai sczut comparativ cu cei peste aceast vrst (p<0,005). 26% dintre diabeticii
aduli sufer de forma LADA. Pacienii provenind din mediul urban au valori de HbA1c semnificativ
mai mici dect cei din mediul rural (p<0,05). Dintre diabeticii obezi cei tineri prezint valori
semnificativ mai ridicate de HbA1c (p<0,05). Echilibrul metabolic glucidic nu prezint diferene
semnificative ntre subgrupele tratate cu antidiabetice orale respectiv cele de insulinonecesitani
(p=0,31). Concluzii: Cu ajutorul dozrii HbA1c se contureaz o subpopulaie de pacieni diabetici care
necesit atenie sporit n vederea prevenirii complicaiilor (adolesceni cu diabet de tip 1, diabetici din
mediul rural, pacieni tineri cu obezitate). Educaia sanitar corespunztoare, modul de via sntos,
urmrirea zilnic a profilului glicemic cu adaptarea dozelor de insulin i determinarea periodic a

HbA1c (de 3-4 ori pe an) ar putea influena benefic echilibrul metabolic glucidic la aceste subgrupe de
diabetici cu risc sporit.
C60. Paraoxonase 1: relationships with disease and activities/ concentration

evaluation
Dronca Maria1, Crciun Elena Cristina2, Micle Otilia3
1. Medical Biochemistry Dept., Faculty of Medicine, Iuliu Haieganu University of
Medicine and Pharmacy Cluj-Napoca, Romania; 2. Dept. of Pharmaceutical Biochemistry
and Clinical Laboratory, Faculty of Pharmacy; Iuliu Haieganu University of Medicine
and Pharmacy Cluj-Napoca, Romania; 3. Microbiology-Histology Dept., Faculty of Medicine
and Pharmacy, Oradea, Romania
Paraoxonase 1 (PON1), an HDL-associated esterase/lactonase, is involved in the detoxification
of organophosphates and protection against oxidative stress. Alteration of the serum PON1 level has
been reported in a variety of diseases involving oxidative stress. These include cardiovascular disease,
chronic liver impairment, metabolic syndrome, chronic renal failure, and some neurodevelopment and
neurodegenerative diseases such as autism and Alzheimers disease. Therefore, increased knowledge of
PON1s physiological significance and involvement in human pathology is now of critical importance.
We review the state-of-the-art regarding PON1 physiological function, relationships with disease, and
methodology used to assay its activities and concentration.
Paraoxonaza 1: patologiile asociate i evaluarea activitilor/ concentraiei

Dronca Maria1, Crciun Elena Cristina2, Micle Otilia3
1. Catedra de Biochimie Medical, Facultatea de Medicin, UMF Iuliu Haieganu Cluj-
Napoca, Romnia; 2. Catedra de Biochimie Farmaceutic i Laborator Clinic, Facultatea de
Farmacie, UMF Iuliu Haieganu Cluj-Napoca, Romnia; 3. Catedra de Microbiologie-
Histologie, Facultatea de Medicin i Farmacie, Oradea, Romnia
Paraoxonaza 1 (PON1), o esteraz/lactonaz asoaciat HDL, este implicat n detoxificarea or-
ganofosforicelor i protecia mpotriva stresului oxidativ. Alterarea nivelului seric al PON1 a fost aso-
ciat cu numeroase boli care implic stresul oxidativ. Acestea includ boala cardiovascular, insufi-
ciena hepatic cronic, sindromul metabolic, insuficiena renal cronic, i unele boli de neurodezvol-
tare i neurodegenerative de tipul autismului i bolii Alzheimer. De aceea, mbogirea cunotinelor
privind semnificaia fiziologic a acestei enzime i implicarea ei n patologia uman este n prezent de
importan critic. n studiul de fa ne-am propus s trecem n revist informaiile la zi privind funcia
fiziologic, patologiile asociate i metodologia utilizat pentru determinarea activitilor i con-
centraiei paraoxonazei 1.
C61. Methods for oxidative stress evaluation: implications in diabetology

Nemes-Nagy Enik1, Balogh-Smrghian Victor1, Ksa Beta2, Zld Gizella2, Czdula
Andrs2, Jk Zsuzsanna2, Snta Dra3,4, Crciun Elena-Cristina5, Dobreanu Minodora6
1. Medical Biochemistry Dept, University of Medicine and Pharmacy, TrguMure; 2.
University of Medicine and Pharmacy, TrguMure, medical student; 3. Santa Polyclinic,
Trgu. Mure, General Practitioner; 4.University of Medicine and Pharmacy, TrguMure,
student (Nutrition and Dietetics); 5. Dept. of Pharmaceutical Biochemistry and Clinical
Laboratory, University of Medicine and Pharmacy Iuliu Haieganu, Cluj Napoca; 6 Dept.
of Clinical Biochemistry and Laboratory, University of Medicine and Pharmacy, TrguMure
Introduction: Reactive oxigen species are involved in development and aggravation of several
diseases, such as diabetes mellitus. The aim of the study is to comparare results obtained with six
methods used to evaluate oxidative stress in diabetic and non-diabetic patients. Materials and
methods: We used three methods to determine malondialdehyde concentration, final product of
lipoperoxidation, Bioxytech LPO 586 reagent kit, and two methods based on the reaction with
thiobarbituric acid. Results were evaluated using the Beckman DU-68 photometer. The activities of
two antioxidant enzymes, superoxide dismutase and glutathion peroxidase were determined with the
analyzer Cobas Mira Plus. To evaluate cutaneous antioxidant status we used a biophotonic scanner
showing the carotenoid score. Results: Malondialdehyde concentration determined by these three
methods correlated well, diabetics presenting significantly higher values than non-diabetic control
patients. In the majority of diabetics we found physiological values of antioxidant enzyme activities.
Carotenoid score was significantly smaller in diabetic patients compared with control people (p<0,05).
Conclusions: Dosage of lipoperoxidation products is a more appropriate method to evaluate oxidative
stress compared with determination of antioxidant enzymes activity. The carotenoid score of the skin
is a modern, non-invazive method to determine the level of protective antioxidants and to evaluate the
intensity of oxidative stress.
Metode de evaluare a stresului oxidativ: implicaii n domeniul diabetologiei

Nemes-Nagy Enik1, Balogh-Smrghian Victor 1, Ksa Beta2, Zld Gizella2, Czdula
Andrs2, Jk Zsuzsanna2, Snta Dra3,4, Crciun Elena-Cristina5, Dobreanu Minodora6
1. Disciplina de Biochimie Medical, UMF TrguMure; 2. UMF TrguMure, student MG; 3.
Cabinet Medicin de Familie, Policlinica Santa,TrguMure;4. UMF TrguMure student
(Nutriie i Dietetic); 5. Disciplina de Biochimie Farmaceutic i Laborator Clinic,
Facultatea de Farmacie, UMFIuliu Haieganu Cluj-Napoca. 6. Disciplina de Biochimie
Clinic i Laborator, UMF TrguMure
Introducere: Speciile reactive ale oxigenului intervin n apariia i agravarea a numeroase stri
patologice printre care se numr i diabetul zaharat. Scopul lucrrii este compararea rezultatelor
obinute prin ase metode care servesc la evaluarea stresului oxidativ la pacieni diabetici i nediabetici.
Material i metod: Pentru dozarea malondialdehidei, produs final al lipoperoxidrii, am utilizat trei
metode: setul de reactivi Bioxytech LPO 586, respectiv dou metode care se bazeaz pe reacia cu acid
tiobarbituric. Rezultatele au fost citite cu fotometrul Beckman DU-68. Dintre enzimele antioxidante am
determinat activitatea superoxid-dismutazei i glutation peroxidazei cu analizorul Cobas Mira Plus. n
vederea evalurii statusului antioxidant la nivel cutanat am utilizat un scanner biofotonic care
determin indicele carotenoizilor. Rezultate: Concentraiile de malondialdehid determinate prin cele
trei metode arat o bun corelaie, diabeticii prezentnd valori semnificativ mai ridicate dect lotul
control nediabetic. Majoritatea pacienilor diabetici au avut valori fiziologice la dozarea enzimelor
antioxidante. Indicele carotenoizilor a fost semnificativ mai mic la diabetici fa de lotul control
(p<0,05). Concluzii: Dozarea produilor de lipoperoxidare este o metod mai potrivit pentru
evaluarea stresului oxidativ comparativ cu analiza activitii enzimelor antioxidante. Determinarea
indicelui carotenoizilor din piele este o metod modern, neinvaziv pentru evaluarea nivelului
antioxidanilor protectori, prin care putem aprecia intensitatea stresului oxidativ.
C62. Gas-Chromatographic analysis of fatty acids from human serum

Ionescu I.1, Pintilie G. Sofia2, David G.3, Dancescu M.3, Oprea Malina4
1. Laboratory of Gas-Chromatography, Dr.Horia Radu National Centre for
Neuromuscular Diseases, Vlcele, Covasna County, Romania; 2. Dept. of Biochemistry and
Human Nutrition, Faculty of Food Products Technology, Banats University of Agricultural
Science and Veterinary Medicine, Timioara; 3. Dept. of Neurosurgery, Queen Maria
Emergency Military Hospital Braov; 4. West Medical Center Braov
Due to their versatility and resolution, chromatographic separations of complex mixtures of bio-
logicals are used for many purposes in academia and industry. If anything, recent developments in the
life sciences have increased the interest and need for chromatography be it for quality control, proteo-
mics or the downstream processing of the high value products of modern biotechnology. However, the
many challenges of present day chromatography and especially of the HPLC of biomacromolecules
such as proteins, are also present in the mind of any practitioner. Fatty acids are essential for human
health; they are required in the body to make important compounds, such as the prostaglandins, leuko-
trienes and thromboxans, which control many important physiological processes. Fatty acids are
present in food as either saturated or unsaturated molecules and, usually, as part of triglycerides. The
properties and biological action of the fatty acids differ greatly, depending on what group they belong
to.
The aim of the present paper was to present our results concerning the composition in the fatty
acids of human serum. Samples were organized in function of age of subjects.
Keywords: fatty acids, gas-chromatographic analysis, human serum
Analize gazcromatografice ale acizilor grai din serul uman

Ionescu I.1, Pintilie G. Sofia2, David G.3, Dancescu M.3, Oprea Malina4
1. Laboratorul Gaz-Cromatografie, Centrul Naional de Patologie Neuro-Muscular Dr.
Horia Radu, Vlcele, jud. Covasna, Romnia; 2. Dept. de Biochimie i Nutriie Uman,
Facultatea de Tehnologia Produselor Agroalimentare, Universitatea de tiine Agricole i
Medicin Veterinar a Banatului, Timioara; 3. Dept. Neurochirurgie, Spitalul de Urgen
Regina Maria Braov; 4. Centrul Medical Vest Braov
Datorit varietii i rezoluiei, separrile cromatografice de amestecuri complexe biologice sunt
folosite n multe scopuri n studiile industriale i academice. Oricum dezvoltrile recente ale tiinelor
vieii au intensificat cerina folosirii cromatografiei n controlul calitii, proteomica proceselor sau
fluxurilor de procesare ale produilor de interes din biotehnologiile moderne. Totui, exist nc multe
provocri ale cromatografiei de azi n special ale HPLC biomacromoleculelor (e.g. proteine). Acizii
grai sunt eseniali pentru sntatea uman, sunt necesari pentru ca organismul s fabrice compui
importani, cum ar fi prostaglandine, leucotriene i tromboxani, care controleaz multe procese fiziolo-
gice. Acizii grai sunt prezeni n alimente ca molecule saturate sau nesaturate i, uzual, ca parte a
trigliceridelor. Proprietile i aciunea biologic a acizilor grai difer considerabil, depinznd de
grupa aparintoare.
Scopul acestui studiu este acela de a prezenta rezultatele noastre referitoare la compoziia aciz-
ilor grai n serul uman. Probele au fost grupate n funcie de vrsta subiecilor.
Cuvinte cheie: acizi grai, analiz gazcromatografic, ser uman
C63. Artificial neural network using in prediction of urinary calculus

component with Fourier Transform Infrared analysis
Pintilie Georgeta Sofia1, Ionescu Iulian2, Zaharie Daniela3, Dragan Petru4
1. Dept. of Biochemistry and Human Nutrition, Faculty of Food Products Technology,
Banats University of Agricultural Science and Veterinary Medicine Timioara; 2. Laboratory
of Gas-Chromatography, National Centre for Neuromuscular Diseases Dr.Horia Radu,
Vlcele, Covasna County, Romania; 3. Dept.of Computer Science, Faculty of Mathematics
and Computer Science, University of Vest Timioara; 4. Clinic of Urology, Victor Babe
University of Medicine and Pharmacy Timioara
The Fourier Transform Infrared (FT-IR) spectroscopy is one of suitable experimental tools for
analysis of urinary calculi constituents. Though, interpretation of infrared spectra for quantifying urin-
ary calculus constituents in mixtures is difficult, requiring expert knowledge by trained technicians.
The develop of automated methods for determining the composition of uroconcremnts is very import-
ant since it can facilitate the determination of the factor which influence the occurrence of calculi in ur-
inary tract and perhaps aid the prevention of their recurrence. We develop a new FT-IR method for ur-
inary calculus analysis. This method uses a computer library and an artificial neural network (ANN)
for spectral interpretation. Recent study have shown that more that 80% of the analyzed of urinary cal-
culi from Banat Region of Romania in our laboratory were mainly composed of calcium oxalate
(whewellite and weddellite) and/or their mixtures with carbonate apatite, struvite, brushite and uric
acid. Then, the focus of this work was development of methods for analysis of urinary calculi com-
posed of these substaces.
The library was prepared from pure substance of these constituents, and 188 mixtures (binary
and ternary of components). The ANN was trained and validated with 72 similar mixtures and tested
with 62 calculi. The discrepancies between calculated and prediction mass fractions of constituents
were in range acceptable for use. We conclude that neural network is promising tools for quantitative
determination of urinary calculus composition and for other related types of analyses in the clinical
laboratory.
Keywords: ANN, calculi, chemical composition, urolithiasis, FT-IR spectroscopy
Folosirea reelelor neuronale articiale n analizele infrarou cu

Transformata Fourier n predicia compoziiei calculilor urinari
Pintilie Georgeta Sofia1, Ionescu Iulian2, Zaharie Daniela3, Dragan Petru4
1. Dept. de Biochimie i Nutriie Uman, Facultatea de Tehnologia Produselor
Agroalimentare, Universitatea de tiine Agricole i Medicin Veterinar a Banatului
Timioara; 2. Laboratorul Gaz-Cromatografie, Centrul Naional de Patologie Neuro-
Muscular Dr. Horia Radu, Vlcele, jud. Covasna, Romnia; 3. Dept. Informatic,
Facultatea de Matematic i Informatic, Universitatea de Vest Timioara; 4. Clinica de
Urologie, UMF Victor Babe Timioara
Spectroscopia infrarou cu Transformat Fourier (FT-IR) este una din metodele corespunztoare
pentru analiza compoziiei calculilor urinari. Totui, interpretarea spectrelor pentru o cuantificare a
constituenilor calculilor micti (formai din mai muli constitueni) este dificil i necesit cunotinele
unui expert n aceast tehnic. Dezvoltarea unor metode automate pentru determinarea compoziiei
uroconcrementelor (calculilor urinari) este foarte important deoarece poate facilita determinarea
factorilor care influeneaz apariia calculilor n tractul urinar i poate ajuta la prevenirea acestei re-
curene. Noi am dezvoltat o nou metod FT-IR pentru analiza calculilor urinari. Aceast metod fo-
losete o bibliotec de date i o reea neuronal artificial (ANN) pentru interpretarea spectral.
Studiile recente au artat c mai mult de 80% dintre calculii analizai provenii din regiunea Banat a
Romniei, din laboratoarele noastre, sunt n principal constituii din oxalat de calciu (whewellite and
weddellite) i/sau amestecul acestuia cu carbonatapatite, struvite, brushite i acid uric. De aceea, acest
studiu s-a concentrat pe dezvoltarea de metode de analiz a compoziiei calculilor urinari compui din
aceste substane. Biblioteca de date a fost dezvoltat din substanele pure ale acestor constitueni i din
188 de amestecuri (binare i ternare ale acestor constitueni). Reelele neuronale artificiale au fost an-
trenate i validate cu 82 de amestecuri similare i testate cu 62 calculi. Discrepana dintre masele
fracionate ale constituenilor calculate i cele prezise au fost n domeniul acceptabil pentru folosire.
Noi am concluzionat c reelele neuronale sunt instrumente de perspectiv pentru determinrile cantit-
ative ale compoziiei calculilor urinari i pentru alte tipuri nrudite de analiz n laboratorul clinic.
Cuvinte cheie: ANN, calculi, compoziie chimic, urolitiaze, spectroscopie FT-IR
Immunology
R64. Overview on serum/ plasma proteome
Funduc Ileana
Proteomic analysis separates, identifies and characterizes proteins and studies their interactions
with other proteins. Plasma or serum is a very precious source for proteomic research because it is a
rich source of proteins, being easy to obtain from patients. The two most abundant proteins in human
serum, albumin and immunoglobulin G (together account for approximately 73% of the total protein
concentration) make the discovery of low abundance proteins difficult. Therefore, by depleting albu-
min and immunoglobulin G, one would anticipate the ability to detect low abundance proteins more
easily and discover useful human serum/plasma protein biomarkers. The traditional approach has been
the use of two-dimensional polyacrylamide gel electrophoresis for protein detection, followed by mass
spectrometry for their identification. As a high quality alternative, further the gel-free liquid chromato-
graphy or other different variants of column or capillary chromatography have been developed; these
used after trypsin-digested peptides and prior to mass spectrometry analysis. The progress of the pro-
teomic analysis provides the better knowledge of plasma or serum proteins as potential biomarkers in
several diseases. By comparing the different protein expression profiles between normal and diseased
plasma/serum samples, valuable information about the process of pathogenesis can be obtained.
Consideraii generale privind proteomul seric/ plasmatic

Funduc Ileana
Analiza proteomic separ, identific i caracterizeaz proteinele, i studiaz interaciile lor cu
alte proteine. Plasma sau serul este o foarte preioas surs pentru cercetarea proteomului deoarece este
bogat n proteine i se obine uor de la pacieni. Cele mai abundente proteine din serul uman, albu-
mina i imunoglobulina G (mpreun reprezentnd aproximativ 73% din concentraia total de pro-
teine) fac dificil descoperirea proteinelor de abunden redus. n consecin, prin depleia albuminei
i a imunoglobulinei G se anticipeaz mult mai uor posibilitatea detectrii proteinelor de abunden
redus i se pot descoperi biomarkerii serici/plasmatici utili. Abordrile tradiionale au folosit electro-
foreza bidimensional n gel de poliacrilamid pentru detectarea proteinelor, urmat de spectrometrie
de mas pentru identificarea lor. Ca o alternativ superioar, ulterior s-au dezvoltat cromatografia
lichid n gel sau alte variante diferite de cromatografie de coloan sau capilar; acestea s-au folosit
dup digestia cu tripsin a peptidelor i naintea spectrometriei de mas. Progresul analizei proteomice
permite o mai bun cunoatere a proteinelor serice sau plasmatice ca biomarkeri poteniali ai unor boli.
Comparnd diferitele expresii ale profilelor proteice n ser/plasm normal i patologic se pot obine
informaii importante asupra procesului de patogenez.
R65. Immune components in colorectal cancer microenvironment

Carasevici Eugen
Immunology and Genetics Laboratory, Gr. T. Popa University of Medicine and Pharmacy, St.
Spiridon Clinic Hospital, Iasi
The main aim of colon cancer management is to cure the disease. The therapeutic tools dedicated
to this are surgery, chemotherapy, molecular targeted therapy, and radiotherapy. The therapeutic plan-
ning need to be adapted to the following criteria: biological complexity of the tumor tissue, clinical
stage of the disease, personalized scheduling of chemotherapy regimen and combination with molecu-
lar targeted therapy.
The colonic tissue is a very complex structure consisting of many cell types with different spe-
cialized cell repertoire and functions.
There are four principal epithelial cell lineages in the colonic tract each displaying variations in
morphology and function in relation to their location: colonocytes, mucin secreting cells known as gob-
let cells, enteroneuroendocrine cells which function in peptide hormone secretion, and Paneth cells
which contain large apical secretory granules and express specific proteins including lysozyme, tumor
necrosis factor and the antibacterial cryptin molecules.
Under normal circumstances the epithelial cell lineages of the intestinal tract undergo constant
turnover, with complete self renewal every 2 7 days.
Besides the epithelial cell lineages, the intestinal tissue include the most extensive and complex
part of the immune system called gut-associated lymphoid tissue (GALT). Structurally GALT is di-
vided in two compartments: a) organized GALT, inductive site for intestinal immune responses
formed by isolated lymphoid follicles, associated lymphoid follicles or Payers patches, and mesenteric
lymph nodes; and b) diffuse GALT effectors of the immune response formed by lymphocyte popula-
tions interspersed among epithelial cells, or intestinal lamina propria.
The immune intestinal system functionally includes the clonal progenitors of three major events
of organ development: the embryo-fetal phase that generates tolerance to the epithelial self structure,
commensal bacterial colonization at birth, and active postnatal responses to non-self structures. A
colorectal tumor develops on this background of receptors and cellular signals that create the tissue mi-
croenvironment.
The fact that the life span of intestinal epithelial cells is shorter than the time required for malig-
nant transformation is an indication that the cryptic stem self-renewing cell is the target of genetic al-
teration eventually leading to a monoclonal origin of the tumor.
Tumor cells, tumor stroma, cells of the immune system influence the induction and behavior of
anti-tumor response. The inflammatory infiltrate, more manifest at the invasion front, can induce toler-
ance or enhance growth even in the presence of specific T lymphocytes.
The colon, which is a tolerogenic organ, can stimulate during the carcinogenesis a deviated mi-
croenvironment, recalling a distorted organogenesis, protective for tumor tissue development, includ-
ing also, for example, an extramedullary hematopoiesis of fetal type.
Componente imune in micromediul cancerului colorectal

Carasevici Eugen
Laboratorul de Imunologie si Genetica, Universitatea de Medicina si Farmacie Gr. T. Popa,
Spitalul Clinic Sf. Spiridon Iasi
Obiectivul principal al tratamentului in cancerul colorectal este vindecarea bolii. Mijloacele tera-
peutice pentru atingerea acestui obiectiv sunt chirurgia, chimioterapia, terapia moleculara tintita si ra-
dioterapia. Planul terapeutic trebuie adaptat urmatoarelor criterii: complexitatea biologica a tesutului
tumoral, stadiul clinic al bolii, personalizarea schemelor de chimio terapie si combinarea cu terapiile cu
tinta moleculara.
Tesutul colonic este o structura foarte complexa formata din numeroase tipuri celulare diferen-
tiate pe un repertoriu functional cu specializari variate.
In tractul colonic exista 4 linii celulare epiteliale principale cu morfologie si functie dependenta
de locul unde sunt pozitionate: colonocitele , celule secretante de mucina goblet, celule enteroneu-
roendocrine secretante de hormoni peptidici si celule Paneth, care contin granule apicale secretorii si
exprima molecule specifice, inclusiv lizozim, TNF si criptine antibacteriene. Turnoverul liniilor epite-
liale in conditii normale, cu o autoreinoire completa, este de 2-7 zile.
Pe langa liniile epiteliale, tesutul intestinal include o componenta vasta si complexa a sistemului
imun numita tesut limfoid asociat intestinului (GALT). Structural GALT este alcatuit din doua compo-
nente: a) GALT organizat, situs de inducere a raspunsurilor imune intestinale - format din foliculi lim-
foizi izolati, foliculi limfoizi asociati (placi Payer) si ganglioni mezenterici; si b) GALT efector difuz -
format din populatii limfocitare raspandite printe celulele epiteliale , sau lamina propria intestinala.
Sistemul imun intestinal contine functional urmasii clonali a trei evenimente majore din dezvol-
tarea organului: perioada embriofetala generatoare a tolerantei fata de structura epiteliala self, popula-
rea cu comensali la nastere, si raspunsurile active postnatale fata de structuri nonself. Tumorile colonu-
lui se dezvolta pe acest fundal de receptori si mesaje celulare, care creeaza micromediul tisular.
Faptul ca durata de viata a celulelor epiteliale intestinale este mai scurta decat timpul necesar in-
ducerii transformarii maligne reprezinta un indiciu ca tinta alterarilor genice este celula intestinala per-
petua, stem, din cripte, leziunile induse fiind probabil monoclonale la origine.
Celulele tumorale, stroma tumorala, celulele sistemului imun influenteaza inductia si comporta-
mentul raspunsului antitumoral. Infiltratul inflamator, mai pronuntat la frontul de invazie, poate, chiar
in prezenta unor limfocite T activate specifice, induce toleranta, sau facilitarea cresterii. Colonul,
considerat un organ tolerogenic, poate stimula in cursul carcinogenezei un micromediu deviat, amin-
tind de organogeneza, protectiv pentru dezvoltare, schitand chiar prin prezenta eritroblastelor,sau nor-
moblastelor cu hemoglobina fetala o hematopoeza extramedulara de tip fetal.
C66. Comparative study of cytokine expression in inflammatory bowel

diseases by multiplex ligation-dependent probe amplification (MLPA) and
quantitative real-time PCR
Iancu C.B., Iancu D., Constantinescu C., Talpes V., Neagu E., Constantinescu A.,
Girbea G., Trandafir C., Gologan S., Diculescu M., Barbarii L.
National Institute of Legal Medicine "Mina Minovici", Bucureti
Introduction: The two main forms of inflammatory bowel diseases (IBD), Crohn disease (CD)
and ulcerative colitis (UC), are characterized by an abnormal inflammatory response of the intestinal
mucosa. Previously reported studies indicated that there is a close correlation between the expression
of cytokines and disease severity.
MLPA is a recently developed method which allows the concomitant analysis of about 40 differ-
ent molecules of nucleic acids.
Aim: Our study aimed to investigate the usefulness of the MLPA method for the investigation of
local expression of a subset of cytokines in the colonic mucosa of IBD patients.
Method: 102 patients (62 BC and 40 UC) were included in our study. Biopsy samples from ap-
parently normal and affected intestinal mucosa were used for total RNA extraction using the RNeasy
kit (Qiagen). Reverse-transcription and MLPA assay was performed using the kit SALSA R009 (MRC
Holland). The amplicons were separated by capillary electrophoresis and the results were normalised
and analysed using an Excel spreadsheet. The overrepresented mRNAs were selected to be further in-
vestigated by quantitative real-time PCR in individual gene expression assays.
Results: MLPA revealed an increased expression of interleukins 1 beta, 6, 8 and 12 (IL12), in
the samples derived from affected mucosa. Quantitative real-time PCR were consistent with the MLPA
results.
Conclusion: MLPA is a fast, reliable and cost-effective method for the screening of inflammat-
ory gene expression profile. However, for the highly expressed genes, real-time PCR is necessary to
precisely evaluate the expression level of the genes.
Studiul comparativ prin MLPA (Multiplex Ligation-Dependent Probe

Amplification) si real-time PCR al profilului de expresie al citokinelor in
bolile inflamatorii intestinale
Iancu C.B., Iancu D., Constantinescu C., Talpes V., Neagu E., Constantinescu A.,
Girbea G., Trandafir C., Gologan S., Diculescu M., Barbarii L.
Institutul Naional de Medicin Legal "Mina Minovici", Bucureti
Introducere: Cele doua forme principale de boli inflamatorii intestinale (IBD), boala Crohn
(CD) si rectocolita ulcero-hemoragica (UC), se caracterizeaza printr-un raspuns inflamator anormal al
mucoasei intestinale. Studiile publicate anterior au aratat ca exista o stransa corelatie intre expresia
genelor cytokinelor si severitatea bolii.
MLPA este o metoda recent descoperita care permite analiza concomitenta a unui numar de 40
de molecule diferite de acizi nucleici.
Scop: Studiul nostru a urmarit evaluarea utilitatii MLPA in investigarea expresiei unui set de
citokine la nivelul mucoasei colonice a pacientilor cu IBD.
Metoda: Au fost investigati 102 pacienti (62 cu CD si 40 cu UC). Din fragmentele bioptice
prelevate de la nivelul mucoasei afectate si din tesut aparent normal s-a extras ARN total cu ajutorul
kitului RNeasy (Qiagen). Revers-transcriptia si testul MLPA s-au efectuat cu ajutorul kitului SALSA
R009 (MRC Holland). Ampliconii au fost separati prin electroforeza capilara iar rezultatele au fost
normalizate si analizate intr-un fisier Excel. ARNm exprimati in cantitate crescuta au fost selectati
pentru a fi investigati in continuare prin real-time PCR.
Resultate: Testul MLPA a evidentiat o expresie crescuta a interleukinelor 1 beta, 6, 8 si 12 la
nivelul mucoasei afectate. Rezultatele MLPA au fost confirmate de cele obtinute la cuantificarea prin
real-time PCR.
Concluzie: MLPA este o metoda rapida si robusta de screening al expresiei genelor inflamatorii,
avand in acelasi timp un bun raport cost/eficienta. Genele cu nivel de expresie mult crescut necesita in-
vestigare suplimentara prin real-time PCR pentru cuantificarea precisa a ARNm.
C67. The Bethesda System - Standardization in reporting cervical cytology

Radulescu Ariadna
Clinical InstituteFundeni, Bucuresti
As of late, more and more women are being diagnosed with uterine cervix cancer. Through cyto-
logical means of investigation, with quick, time- and material economic and easy to approach methods,
the cancer can be easily discovered in an incipient stage and can offer the physician information about
the lesions in the genital area.
From the first records (1928 A Babes and 1933 G. Papanicolau) and up to now the prelevation
and coloration techniques, terminology and classification systems kept improving.
The Bethesda system, as a cytodiagnostic method of reporting cervico-vaginal cancer, was intro-
duced in 1991 and 2001 in order to standardize the means of identifying and researching the disease,
helping the gynecologist in establishing the right course of treatment. The Bethesda system has two
main parts: evaluation of specimen adequacy and general characterization.
It is classified into three:
normal limits
benign cell alteration which may imply also infection, including typical repair and reactive
cellular changes
epithelial and glandular cell anomalies which comprise dysplasia (pre-cancerous) and neo-
plasia (cancerous)
False negative results are more frequent than false positive results. These controversies are re-
lated to more parameters like technical quality, but they can be minimized.
In order to be correct, the screening must be standardized, must have an output, a high sensibil-
ity, without underestimating borderline lesions, which can be more severe than the overestimated ones.
The purpose of the Papanicolau test is to reduce the number of patients with an indecisive result and
the risk of having a high degree intraepithelial lesion.
Sistemul Bethesda Standardizare n raportarea citologiei cervico-vaginale

Rdulescu Ariadna
Institutul Clinic Fundeni, Bucureti
n ultima perioad se cunoate o cretere a numrului de persoane care sufer de cancer al colu-
lui uterin. Prin metode citologice de investigare, metode rapide, cu economie de timp i materiale, usor
abordabile, se poate depista n faz incipient aceast afeciune, punnd la ndemna clinicianului in-
formaii asupra leziunilor din sfera genital.
De la primele semnalri (1928 A. Babe i 1933 G. Papanicolaou) i pn n prezent, tehni-
cile de prelevare, de colorare, terminologia i sistemul de clasificare s-au tot mbuntit.
Sistemul Bethesda ca sistem de raportare a citodiagnosticului cervico-vaginal a fost propus n
1989, mbuntit n 1991 i 2001, pentru a uniformiza modul de a identifica i a face cunoscut boala,
ajutnd ginecologul n stabilirea terapiei.
Sistemul Bethesda cuprinde doua pri: gradul de adecvare a frotiului i caracterizarea general.
Clasificarea cuprinde trei pri:
n limite normale
modificri celulare benigne, care cuprinde infecii, modificri reparative i reactionale
anomalii ale celulelor epiteliale i neoplazii (precanceroase i canceroase)
Rezultatele fals negative sunt mai frecvente dect cele fals pozitive. Aceste discordane sunt leg-
ate de mai muli parametri, calitatea tehnic, dar se pot diminua.
Pentru ca screening-ul s fie valoros trebuie s fie standardizat, s aib randament, sensibilitate
nalt, s nu subestimeze leziunile borderline, care sunt mai grave dect cele de supraestimare.
Scopul testului Papanicolaou este de a diminua numrul pacientelor cu scor neconcludent i risc
de a avea o leziune intraepitelial de grad nalt.
C68. Experimental investigation of the most suitable osteoblast-

differentiation media for human adult stem cells
Tomuleasa Ciprian,, Soriu Olga , Pall Emke , Foris Vasile ,, Lung Valentin, Piciu
Doina 1
1.Iuliu Haieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;
2. Laboratory of Experimental Radiotherapy and Stem Cell Culture,Prof. Dr. Ion Chiricu
Oncology Institute, Cluj-Napoca; 3. Department of Animal Reproduction, University of
Veterinary Medicine and Agricultural Sciences, Cluj-Napoca
Introduction. Stem cell research is a rapidly expanding area of investigation with the ultimate
goal to prevent, diagnose and treat various human diseases. By using the most specific culture medium
and thus activating certain intercellular signaling pathways, adult stem cells become osteoblasts. This
study challenges current protocols by comparing the proliferation effects of different growth factors
thought to influence bone genessis.
Material and Methods. Adult stem cells isolated from the human bone marrow and osteoblasts
isolated from human patella bone are used. Before starting differentiation protocols we identified spe-
cific surface markers for stem cells (SSEA-4, CD29, CD105, Oct , Nanog and SOX2) and osteoblasts
(Osteopontin and Osteonectin). We investigate the proliferation (MTT assay) , the intensity of the min-
eralization process by histology stainings (Alizarin Red S, Alcian Blue and von Kossa) and the pres-
ence of alkaline phosphatase in 3 cell culture models: undifferentiated stem cells, predifferentiated
stem cells on Matrigel substrate and osteoblastic cells. Cells were cultured in simple osteogenic media
and complex medias, supplemented with growth factors: Transforming Growth Factor , Bone
Morphogenic Protein-2, basic Fibroblast Growth Factor, Insulin Growth Factor, Epidermal Growth
Factor and comercial serum-free Promocell media for osteoblasts. For the controls we used
DMEM/F12 with FCS, L-Glutamine and antibiotics.
Results. The MTT assay revealed that stem cell proliferation is most stimulated by IGF and ser-
um-free Promocell media. The most intensive proliferation response was to IGF in all 3 cell culture
models, but osteoblasts show the highest sensitivity. Stem cells precultivated on matrigel substrate
were more sensitive to FGF, IGF, and EGF. Cells cultured in medias with IGF and EGF have intense
Anti-Alkaline Phosphatase staining.
Conclusion. The isolation of human stem cells offers the promise of a remarkable array of novel
therapeutics through tissue regeneration and repair, from orthopedics to plastic and reconstructive sur-
gery.
Investigarea experimental a celui mai eficient mediu de difereniere

osteoblastic pentru celulele stem adulte
Tomuleasa Ciprian,, Soriu Olga , Pall Emke , Foris Vasile ,, Lung Valentin , Piciu
Doina 1
1.Iuliu Haieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania;
2. Laboratory of Experimental Radiotherapy and Stem Cell Culture,Prof. Dr. Ion Chiricu
Oncology Institute, Cluj-Napoca; 3. Department of Animal Reproduction, University of
Veterinary Medicine and Agricultural Sciences, Cluj-Napoca
Introducere. Cercetarea celulelor stem reprezint un domeniu medical n continu expansiune,
cu scopul suprem de a preveni, diagnostica i trata diferite afeciuni considerate a fi incurabile. Fo-
losind cel mai potrivit mediu de difereniere i activnd anumite semnale intercelulare, celulele stem se
pot diferenia n osteoblati mineralizai. Acest studiu completeaz protocoalele curente prin com-
pararea efectelor proliferative ale diferiilor factori de cretere posibil implicai n osteogenez.
Materiale i Metode. Sunt folosite celule stem adulte izolate din maduva osoas i osteoblati
izolai din patella uman. nainte de difereniere, am identificat markeri de suprafa specifici celulelor
stem (SSEA-4, CD29, CD105, Oct , Nanog i SOX2) ori osteoblatilor (Osteopontin i Osteonectin).
Am investigat rata proliferrii (testul MTT), intensitatea mineralizrii prin coloraii histologice (Alizar-
in red S, Alcian blue i von Kossa) i prezena izoenzimei fosfataza alcalin utiliznd trei linii de celule
stem: celule nedifereniate, celule predifereniate pe substrat de Matrigel i osteoblati. Celulele sunt
cultivate att n mediu osteogenic simplu ct i complex, suplimentat cu Transforming Growth Factor
, Bone Morphogenic Protein-2, basic Fibroblast Growth Factor, Insulin Growth Factor, Epidermal
Growth Factor i mediu comecial serum-free Promocell. Pentru control, am utilizat DMEM/F12 cu
FCS, L-Glutamin i antibiotice.
Rezultate. Testul MTT demonstreaz c rata proliferrii este cel mai mult stimulat de IGF i
mediu Promocell iar celulele sunt cel mai senzitive la aciunea IGF n cazul tuturor liniilor. Cei mai
sernsibili sunt osteoblatii. Celulele stem precultivate pe Matrigel sunt mai sensibile la aciunea FGF,
IGF i EGF. Celulele cultivate cu IGF i EGF prezint coloraia fosfataza alcalin cea mai intens.
Concluzii. Izolarea celuleleor stem umane ne ofer premisele unei remarcabile game de opiuni
terapeutice prin intermediul ingineriei tisulare, cu aplicaii de la ortopedie la chirurgia plastic i recon-
structiv.
Posters 1. Microbiology
P1. Tap water as a potential source of nosocomial Pseudomonas aeruginosa
infections in an intensive care unit
Barna Zsfia 1, Antmann Katalin 2, Pszti Judit 3, Nmeth Melinda 2, Bnfi Renta 1, Vargha
Mrta 1
1. National Institute for Environmental Health Budapest, Hungary; 2. Semmelweiss

University Budapest, Hungary; 3. National Institute for Epidemiology Budapest, Hungary
P. aeruginosa is a frequent cause of nosocomial infections in intensive care units. The water dis-
tribution system, tap and shower points of use may often serve as reservoirs for pseudomonads.
The aim of the present study was to assess the effect of point-of-use filters on
(1) P. aeruginosa counts in tap water
(2) incidence of Pseudomonas spp. infections in an ICU
(3) incidence of clinical and environmental Pseudomonas spp. strains, in order to provide evid-
ence for water-related infection.
The study was carried out in a 12 bed intensive care unit of a Hungarian hospital. Point-of-use
filters were applied to all water outlets for 2 x 2 weeks. Tap water was sampled weekly before, during
and after the use of the filters. Environmental P. aeruginosa strains were isolated from tap water and
compared to clinical isolates.
Strains: 13 clinical and 101 and environmental strains;
Methods: sero-, phage-and pyocin typing, PFGE;
Three of five tap outlets were found to be initially colonized by P. aeruginosa. Application of
the point-of-use filters eliminated P. aeruginosa as well as other waterborne bacteria from the tap wa-
ter during the two weeks of usage.
There were no new clinical cases of Pseudomonas infections identified during the use of the fil-
ters, whereas an average of 6 cases/month was recorded during the preceding 2 years.
Environmental isolates clustered into two groups by all of the employed typing methods; sero-
types O1 and O10 were discerned. PFGE profiles of the clinical isolates showed high (>90%) similar-
ity to the environmental strains.
In conclusion, typing results supported the hypothesis that tap water and/or taps are likely reser-
voirs of infective strains. Point-of-use filters were found to be effective means for the infection control
of pseudomonads.
In conclusion, typing results supported the hypothesis that tap water and/or taps are likely reser-
voirs of infective strains. Point-of-use filters were found to be effective means for the infection control
of pseudomonads.
P2. Gram-positive germs isolated from urocultures in ambulatory and

wards with surgical risk
Berceanu Vduva Delia, Muntean Delia, Velimirovici Dana, Rdulescu Matilda,
Berceanu Vduva M., Dugeescu Dorina, Stng Livia, Prvan Ramona, Popa Mihaela,
Moldovan Roxana
"Victor Babe University of Medicine and Pharmacy, Timioara
Objectives: We propose a comparative study of sensitivity to antibiotics of gram-positive germs
isolated in urocultures from patients in ambulatory and two wards with surgical risk (urology and ob-
stetrics-gynecology), and also to establish the resistance phenotypes of these strains.
Material and method: 28 S. aureus strains were studied, 24 strains of negative-coagulase Sta-
phylococcus (SCN), 23 Streptococcus agalactiae strains, 1 Streptococcus anginosus strain and 48 En-
terococcus spp. strains. The isolated strains came from 4398 urocultures (1889 ambulatory, 1871
urology, 629 - obstetrics-gynecology).
Testing of antibiotic sensitivity was performed through Kirby-Bauer disk-diffusion method, with
automatic phenotyping (Osiris Evolution system).
Results: In ambulatory, the wild phenotype was predominant in all isolated strains (33.33% S.
aureus, 50% SCN, 100% Streptococcus aglactiae, 60% Enterococcus spp.). In the urology ward, the
following multiresistant strains were isolated: 9 MRSA strains (47.36%), 1 MRSE strain (100%), 1
VRE strain (4.34%). In the obstetrics-gynecology ward, 7 strains showed multiple antibiotic resistance:
4 MRSA strains (66.66%), 2 MRSE strains (50%), 1 VRE strain (6.66%).
Conclusions: Multiresistant strains were isolated in hospital environment, which can be ex-
plained by the improper use of antibiotics, the instrumental approach of the urinary tract, and the exist-
ence of risk factors in the patients admitted in the above-mentioned wards. Enforcement of efficient
nosocomial infection control measures is advisable, as well as a policy for rational antibiotic use.
Germeni Gram-pozitivi izolai din uroculturi provenite din ambulator i

secii cu risc chirurgical
Berceanu Vduva Delia, Muntean Delia, Velimirovici Dana, Rdulescu Matilda,
Berceanu Vduva M., Dugeescu Dorina, Stng Livia, Prvan Ramona, Popa Mihaela,
Moldovan Roxana
Universitatea de Medicin i Farmacie "Victor Babe" Timioara
Obiective: Ne-am propus s realizm un studiu comparativ al sensibilitii la antibiotice a ger-
menilor Gram-pozitivi izolai din uroculturi provenite de la pacieni din ambulator i din dou secii cu
risc chirurgical (urologie i obstetric-ginecologie) i totodat s stabilim fenotipurile de rezisten n
care se ncadreaz aceste tulpini.
Material i metod: S-au luat n studiu 28 tulpini de S. aureus, 24 tulpini de stafilococ co-
agulazo-negativ (SCN), 23 tulpini de Streptococcus agalactiae, 1 tulpin de Streptococcus anginosus i
48 tulpini de Enterococcus spp.
Tulpinile izolate au provenit dintr-un numr de 4398 uroculturi (1889 ambulator, 1871 urolo-
gie, 629 - obstetric-ginecologie).
Testarea sensibilitii la antibiotice s-a realizat prin metoda difuzimetric Kirby-Bauer, iar n-
cadrarea n fenotipuri de rezisten a tulpinilor izolate s-a realizat cu ajutorul analizorului Osiris Evolu-
tion.
Rezultate: n ambulator, la toate tulpinile izolate a predominat fenotipul sensibil (33,33% S.
aureus, 50% SCN, 100% Streptococcus aglactiae, 60% Enterococcus spp.).
n secia de urologie s-au izolat urmtoarele tulpini multirezistente la antibiotice: 9 tulpini
MRSA (47,36%), 1 tulpin MRSE (100%), 1 tulpin VRE (4,34%).
Din secia obstetric-ginecologie 7 tulpini au prezentat multirezisten la antibiotice: 4 tulpini
MRSA (66,66%), 2 tulpini MRSE (50%), 1 tulpin VRE (6,66%).
Concluzii: Tulpinile multirezistente au fost izolate din mediul spitalicesc, fapt explicat prin util-
izarea necorespunztoare a antibioticelor, prin abordarea instrumental a cilor urinare i existena unor
factori de risc la pacienii internai n seciile luate n studiu. Se impune instituirea unor msuri eficace
de control ale infeciilor nosocomiale i introducerea unor politici de utilizare raional a antibioticelor.
P3. Bacterial species involved in urinary tract infections in outpatients

Micle Otilia1, Popa Daniela1, Mortan Ramona2, Apati Estera2, Teaha Monica1
1. Faculty of Medicine and Pharmacy of Oradea, Microbiology-Histology Department;
2. Bioclinica Laboratory of Oradea
Objective. The aim of this study was to establish the bacterial etiology in urinary tract infections
in outpatients of different age.
Material and methods. Between september 2008 march 2009 in a private laboratory of Oradea
were done a number of 757 urocultures with the purpose to establish UTI diagnosis. Collected samples
were inoculated on Urichrom media using calibrated loop-direct streak method. In each positive uro-
culture, specific methods of identification, AST through the Kirby-Bauer disc diffusion method and
Vitek 2 system for identification and evaluation of resistance to antibiotics were used.
Results. From all samples taken, 202 (26,68%) were positive, in 97% of these monobacterial
etiology was involved. UTI occured in 166 cases (82,18%) in women and in 36 cases (17,82%) in men.
The distribution by age groups is the following: 43 cases (21,28%) in patients up to 20 years, 62 cases
(30,70%) in patients between 21 and 40 years, 58 cases (28,71%) in patients between 41 and 60 years,
and the rest of 39 cases (19,30%) in patients over 61 years. First place is ocuppied by species from En-
terobacteriaceae family: Escherichia coli was isolated in 117cases (57,92%); Klebsiella pneumoniae in
17 cases (8,41%); Proteus mirabilis in 4 cases (2 %); Klebsiella oxytoca in 3 cases (1,48%); En-
terobacter aerogenes in 2 cases (1 %) and Proteus vulgaris, Morganella morganii, Citrobacter freun-
dii, Enterobacter cloacae in one case each (0,5 %). Other etiological agents involved in UTI, in order
of their frequency are: Enterococcus faecalis in 29 cases (14,35%); Streptococcus agalactiae in 12
cases (5,94%); Pseudomonas aeruginosa in 4 cases (2 %); Staphylococcus saprophyticus in 3 cases
(1,48%); Staphylococcus aureus in one case (0,5 %).
Conclusions. Bacterial infections of the urinary tract most commonly affect women, and age
groups between 21-40 and 4160 years. It has been found a wide variety of bacteria involved in UTI,
first place is occupy by Escherichia coli, followed by Enterococcus faecalis and Klebsiella pneumoni-
ae.
Genuri i specii bacteriene implicate n etiologia infeciilor tractului urinar

la pacieni din ambulator
Micle Otilia1, Popa Daniela1, Mortan Ramona2, Apati Estera2, Teaha Monica1
1. Facultatea de Medicin i Farmacie din Oradea, Catedra Microbiologie-Histologie;
2. Laboratorul Bioclinica din Oradea
Obiectiv. Studiul de fa urmrete stabilirea etiologiei bacteriene n cazul infeciilor tractului
urinar aprute la diferite grupe de vrst.
Material i metode. n perioada septembrie 2008 martie 2009 n cadrul unui laborator privat
din Oradea au fost efectuate un numr de 757 uroculturi, n vederea stabilirii diagnosticului de infecie
urinar. Probele recoltate au fost nsmnate pe mediul cromogen Urichrom, folosind metoda ansei
calibrate. Pentru fiecare urocultur pozitiv s-au utilizat metodele specifice de identificare i testare a
sensibilitii la antibiotice prin metoda difuzimetric Kirby-Bauer, respectiv sistemul de identificare i
evaluare a rezistenei la antibiotice Vitek 2 Biomerieux.
Rezultate. Din totalul uroculturilor efectuate, 202 (26,68%) au fost pozitive, n 97% dintre
acestea fiind stabilit etiologia monobacterian. Infeciile urinare au survenit n 166 cazuri (82,18%) la
femei, respectiv n 36 cazuri (17,82%) la brbai. Repartiia pe grupe de vrst este urmtoarea: 43 de
cazuri (21,28%) la pacienii sub 20 de ani, 62 de cazuri (30,70%) la pacienii ntre 21 i 40 de ani, 58
de cazuri (28,71%) la pacienii ntre 41 i 60 de ani, respectiv 39 de cazuri (19,30%) la pacienii de
peste 61 de ani. Primul loc n producerea ITU este ocupat de specii aparinnd familiei Enterobacteri-
aceae, astfel: Escherichia coli s-a izolat n 117 cazuri (57,92%); Klebsiella pneumoniae n 17 cazuri
(8,41%); Proteus mirabilis n 4 cazuri (2 %); Klebsiella oxytoca n 3 cazuri (1,48%); Enterobacter
aerogenes n 2 cazuri (1 %), iar speciile Proteus vulgaris, Morganella morganii, Citrobacter freundii,
Enterobacter cloacae n cte un caz fiecare (0,5 %). Ali ageni etiologici ai ITU au fost, n ordinea
frecvenei implicrii lor: Enterococcus faecalis n 29 de cazuri (14,35%); Streptococcus agalactiae n
12 cazuri (5,94%); Pseudomonas aeruginosa n 4 cazuri (2 %); Staphylococcus saprophyticus n 3
cazuri (1,48%) i Staphylococcus aureus ntr-un caz (0,5 %).
Concluzii. Infeciile bacteriene de tract urinar afecteaz mai ales sexul feminin, cel mai frecvent
implicate fiind grupele de vrst cuprinse ntre 21 i 40 de ani, respectiv 41 i 60 de ani, n proporii re-
lativ egale. Se constat o mare diversitate de specii bacteriene implicate n etiologia ITU, primul loc fi-
ind ocupat de Escherichia coli, urmat de Enterococcus faecalis i Klebsiella pneumoniae.
P4. Bacteriological control and self-control in a city hospital from North-

Western Romania
Teaha Monica, Popa Daniela, Pelea Diana
Microbiology-Histology Department, Faculty of Medicine and Pharmacy, University of
Oradea
Nosocomial infections remain a reality in the contemporary period. Prevention in the field of
nosocomial infections is a permanent action which starts with the design and construction of medical
facilities and continues with daily control-self control.
Laboratory tests represent the most objective and accurate epidemiological survey method.
The study was performed in a municipal hospital in north-western Romania by examining the
conditions of hygiene and sanitation and by bacteriological examination of aeromicroflora, surface,
sterilized instruments, hands of medical staff.
The results demand a reassessment of hospital functional circuits, correct disinfection techniques
and providing an optimal level of health education for both medical staff and patients.
Controlul i autocontrolul bacteriologic ntr-un spital municipal din nord-

vestul Romniei
Teaha Monica, Popa Daniela, Pelea Diana
Catedra Microbiologie-Histologie, Facultatea de Medicin i Farmacie, Universitatea din
Oradea
Infeciile nosocomiale rmn o realitate n epoca contemporan. Prevenia n infeciile nosoco-
miale este o aciune cu caracter permanent, care ncepe cu proiectarea i execuia unei uniti medico-
sanitare i continu cu controlul autocontrolul zilnic.
Determinrile de laborator constituie cea mai obiectiv i exact metod de supraveghere epi-
demiologic.
Studiul s-a realizat ntr-un spital municipal din nord-vestul rii, prin inventarierea condiiilor ig-
ienico-sanitare i examenul bacteriologic al aeromicroflorei, al florei de pe suprafee, de pe instru-
mentele sterilizate, precum i de pe minile personalului medical.
Rezultatele obinute impun o reevaluare a circuitelor din spital, efectuarea corect a dezinfeciei
i asigurarea unui nivel de educaie sanitar optim pentru personal i bolnavi.
P5. Immune, viral and resistance mutations after 48 months of HAART

therapy in HIV/AIDS patients
ilea Brindua1, Chiriac Carmen1, Dobreanu Minodora2, Fodor Andrea2
1. First Infectious Disease Clinic, University of Medicine and Pharmacy Trgu Mure;
2. Dept. Of Clinical Biochemistry, Molecular Biology Laboratory, University of Medicine and
Pharmacy Trgu Mure
Background: Assessment of HAART (Highly Active Antiretroviral Therapy) efficiency therapy
in treatment or pre-treated HIV seropositive patients.
Methods: A number of 45 HIV patients A3-C3 stage, during a median follow-up period of 48
months (2005, January, 10 2009, January, 30) who received HAART therapy: 2NRTI+PI;
NRTI+NNRTI+PI; NRTI+2PI; containing as PI: Lopinavir/Ritonavir(LPV/r), were assessed immuno-
logical, viral, and resistance mutations identification in HIV/AIDS Dept. of Infectious Disease Clinic
Trgu-Mure. Genotypic assays were performed in National Institute of Infectious Diseases Prof. Dr.
Matei Bal, Bucharest and the interpretation was made on the ANRS 2006 algorithm.
Results: The patients age was between 13-17; there were 51% males and 49% females. The
therapeutic formulas were: 2NRTI+LPV/r (89% pts), NRTI+NNRTI+LPV/r (7% pts), NRTI+PI+LPV/
r (4% pts). At the end of the study 51% patients had an undetectable viral load (HIV-RNA copies be-
low 400/ml), 56% patients had CD4 count>500 cells/mm3. Major and secondary resistance mutations
of viral proteases were found in 22% patients. The most frequent side-effects noticed were: hypercho-
lesterolemia (33% pts.), diarrhea (18% pts.), hypertriglyceridemia (11% pts.).
Conclusions: HAART regimens used had a great efficiency at pre-treated patients with an evid-
ent immunological restoration and an important viral suppression.
Aspecte imunologice, virusologice, mutaii de rezisten dup 48 de luni de

terapie HAART la pacienii cu HIV/SIDA
ilea Brndua1, Chiriac Carmen1, Dobreanu Minodora2, Fodor Andrea2
1. Clinica Boli Infecioase 1, Universitatea de Medicin i Farmacie Trgu Mure; 2.
Disciplina de Biochimie Clinic, Laboratorul de Biologie Molecular, Universitatea de
Medicin i Farmacie Trgu Mure
Obiective: Evaluarea i monitorizarea eficacitii terapiei HAART (Highly Active Antiretroviral
Therapy) la pacienii seropozitivi HIV pretratai.
Material i metod: S-au urmrit imunologic, virusologic dar i identificarea unor mutaii de
rezisten ale PT-HIV1 subtipul F, la 45 de pacieni cu infecie HIV/SIDA ncadrai n stadiile A3-C3 de
boal, care au beneficiat de urmtoarele formule de terapie antiretroviral: 2INRT+IP;

INRT+INNRT+IP; INRT+2IP; coninnd ca inhibitor de proteaz (IP) Lopinavir/Ritonavir (LPV/r).
Monitorizarea s-a efectuat la Clinica Boli Infecioase 1, Compartimentul HIV/SIDA pe o perioad de
48 de luni (10 ianuarie 2005 30 ianuarie 2009). Genotiparea a fost realizat la Institutul Naional de
Boli Infecioase Prof. Dr. Matei Bal, Bucureti, iar interpretarea rezultatelor s-a efectuat n baza al-
goritmului ANRS 2006.
Rezultate: Vrsta pacienilor studiai a fost cuprins ntre 13 - 17 ani, 51% de sex masculin,
49% sex feminin. Formulele terapeutice utilizate au fost: 2INRT+Lpv/r n 89% din cazuri, INRT+IN-
NRT+Lpv/r n 7% din cazuri; INRT+IP+Lpv/r n 4% din cazuri. La finalul studiului 51% din pacieni
au prezentat o ncrctur viral nedetectabil (HIV-ARN<400 copii/ml), 56% din pacieni un numr
de limfocite T CD4>500 celule/mm3. Mutaii majore i secundare de rezisten ale proteazei virale au
fost constatate la 22% din pacieni. Cele mai frecvente efecte adverse au fost: hipercolesterolemie
(33%), diaree (18%), hipertrigliceridemie (11%).
Concluzii: Terapia HAART administrat pacienilor pretratai pe termen lung a fost eficient
rezultnd o restaurare imunologic evident i o supresie viral important.
P6. Dosage of the arylsulphatase A enzymes seric activity in HIV

seropositive patients
Kastal Timea1, Zaharia-Kzdi Iring2, Balogh-Smrghian V.3, Fazakas Zita3
1. Student at the University of Medicine and Pharmacy, Tg Mures; 2. Department of
Infectious diseases - University of Medicine and Pharmacy, Tg. Mures; 3- Department of
Biochemistry- University of Medicine and Pharmacy, Tg. Mures
Several psychical diseases can occur in HIV infected patients. Anxiety symptoms and major
anxiety diseases occur frequently. Psychical diseases can be caused directly by HIV, opportunistic
infections, metabolic disorders and treatment. Madness associated with the immunodefficiency
syndrome and other psychical diseases occur at a rate of 10 % in the initial phase, 70 % as the illness
progresses and abnormalities can be noticed in 90% of the patients in case of autopsy of the central
nervous system. We can notice the low level of arylsulphatase A (ASA) in case of children and adult
patients with neuropsychiatric diseases. The ASA catalyzes the cerebrozid-3-sulphate hydrolisis, a
substance which is found in high concentration in myeline constituting 3-4% of the total membrane
lipids. The low level of ASA enzyme activity frequent in adults with different psychical diseases,
suggests that people can have sulphatase defficiency without any symptoms, the behavioral and
functional problems in case of these patients may be related to sulphatase defficiency.
The purpose of the paper is to determine the ASA enzymes seric activity in HIV seropositive
patients.
Material and method: we included in the study 51 patients from the Clinical Hospital of Infec-
tious Diseases in Trgu Mures. We determined the ASAs activity through spectrophotometry. The
method of enzyme dosage is based on a 4 hour-long hydrolysis of the ASA enzyme on 4-nitrocatechol
sulphate substratum.
Results: In case of healthy patients the ASA activity is between 30-130 nmol/ml serum/4 hour,
in case of unhealthy patients the average enzyme activity is 0,1318 0,085 nmol/ml serum/4 hour. Ac-
cording to our study the unhealthy patients have a very low enzyme activity, not even the maximum
value of the enzyme (ASA= 0,368 nmol/ml serum/4 hours) reaches the minimum value of normal ASA
activity. Based on the dramatical decrease of the enzymes seric activity we can conclude that the
ASA enzyme might play a role in the HIV infected patients neuropathology.
Dozarea activitii serice al enzimei arilsulfataza A la pacieni

seropozitivi HIV
Kastal Timea1, Zaharia-Kzdi Iring2, Balogh-Smrghian V.3, Fazakas Zita3
1. UMF Tg. Mure, student MG VI; 2. UMF Tg. Mure, Disciplina de Boli Infecioase;
3. UMF Tg. Mure, Disciplina de Biochimie
Mai multe boli psihice au fost raportate la indivizi infectai cu virusul imunodeficienei umane
(HIV). Simptomele de anxietate i boli anxioase majore apar frecvent la aceti pacieni. Bolile psihice
pot fi cauzate de HIV, infecii oportuniste, dezorganizare metabolic sau de tratament. Demena
asociat cu sindromul imunodeficienei dobndite (SIDA) i alte boli psihice sunt prezente la 10% din
pacieni n faza iniial, 70% n cursul bolii, iar 90% prezentau anormaliti la autopsia sistemului
nervos central. Se raporteaz nivelul sczut al enzimei arilsulfataz A (ASA) la copii i aduli cu boli
neuropsihiatrice. Arilsulfataza A catalizeaz hidroliza cerebrozid-3-sulfatului, substan care se gsete
n concentraie crescut n mielin, constituind 3-4 % din totalul lipidelor membranare. Prezena
nivelului sczut al activitii enzimatice ASA la un numr reprezentativ la aduli, cu diferite manifestri
psihiatrice, sugereaz c aceti pacieni pot fi purttori asimptomatici ai defectului sulfatazei;
tulburrile comportamentale i funionale la aceti pacieni pot fi corelate cu deficitul sulfatazei.
Scopul lucrrii este determinarea activitii serice a enzimei ASA la pacieni HIV seropozitivi.
Material i metod. Au fost inclui n studiu 51 bolnavi internai la Spitalul de Boli Infecioase
din Trgu Mure. S-a determinat activitatea arilsulfatazei A prin metoda spectrofotometric. Metoda
dozrii enzimatice se bazeaz pe reacia de hidroliz a 4-nitrocatechol-sulfatului catalizat de aril-
sulfataza A.
Rezultate: In cazul indivizilor sntoi activitatea ASA este cuprins ntre 30-130 nmol/ml ser/4
ore, iar n cazul bolnavilor activitatea medie a enzimei este 0,1318 0,085 nmol/ml ser/4 ore. Conform
studiului nostru bolnavii au activitatea enzimatic foarte sczut, nici valorile maxime constatate
(ASA= 0,368 nmol/ml ser/4 ore) neatingnd valoarea minim a activitii ASA normal.
Avnd n vedere aceast scdere marcant a activitii serice a enzimei, putem trage concluzia,
c ASA ar putea juca un rol important n neuropatogenez, la pacieni infectai cu HIV.
P7. The prevalence of mycotic infections in allergic patients with ENT

pathology
Rdulescu Matilda1, Licker Monica1, Moldovan Roxana1, Bdioiu Luminia1, Admu
Marcela1, Berceanu Vduva Delia1, Crciunescu Mihaela1, Muntean Delia1, Popa
Mihaela1, Poenaru Mrioara2
1. University of Medicine and Pharmacy Timioara; 2. Clinical Municipal Hospital Timioara
Purpose: The study is part of PNII- 41-011/2007 project and its objective is to assess the
distribution of fungi species in samples collected from allergic patients with ENT pathology and
antifungal sensitivity tests results, between 1.01.2008-15.03.2009.
Material and method: Samples (pharyngeal and nasal swabs, ears/surgical site/parotid
secretions) have been collected from patients in hospital environment and ambulatory. Fungi
identification was performed using both API Candida (BioMerieux) and Candifast systems
susceptibility tests were performed by classical disk-difussion method and on Candifast galeries.
Results: From the total number of 402 collected samples, we isolated 62 fungi strains. The suc-
cession of species distribution was: C. albicans 69,35%, A. niger 8,06%, C. tropicalis 6,45%, C.
famata and C. parapsilosis 3,22 %, followed by C. lusitaniae, C. flavus 1,61%, etc. Most C. albicans
strains were resistant to Amphotericin B and 5 Fluorocytosine.
Conclusions: C. albicans represents the most isolated fungi species. The majority of C. albicans
strains were resistant to Amphotericin B and 5 Fluorocytosine. Both identification systems have a
similar performance, but in terms of susceptibility testing, Candifast system performances are superior.
Prevalena infeciilor fungice la pacientul alergic cu patologie ORL

Rdulescu Matilda1, Licker Monica1, Moldovan Roxana1, Bdioiu Luminia1, Admu
Marcela1, Berceanu Vduva Delia1, Crciunescu Mihaela1, Muntean Delia1, Popa
Mihaela1, Poenaru Mrioara2
1. Universitatea de Medicin i Farmacie Timioara; 2. Spitalul Clinic Municipal
Timioara
Obiectiv: Studiul face parte din proiectul PNII Nr. 41-011/2007 i are ca obiectiv evaluarea
distribuiei speciilor de fungi din produse patologice ale pacienilor alergici din sfera ORL i testarea
sensibilitii lor la preparate antifungice, n perioada 1.01.2008-15.03.2009.
Material i metod: Produsele patologice (exsudate faringiene, nazale, secreii otice / de plag /
parotid) au fost prelevate de la pacieni spitalizai sau din ambulatoriu. Identificarea fungilor s-a
efectuat n paralel pe API Candida (BioMerieux) i galerii Candifast, iar testele de sensibilitate prin
metoda difuzimetric clasic i galerii Candifast.
Rezultate: Din totalul de 402 probe recoltate n perioada mai sus menionat, am izolat un
numr de 62 de fungi. Ordinea distribuiei speciilor a fost: C. albicans 69,35%, A. niger 8,06%, C.
tropicalis 6,45%, C. famata i C. parapsilosis 3,22%, urmate de C. lusitaniae, C. flavus 1,61%, etc.
Majoritatea tulpinilor de C. albicans au fost rezistente la Amphotericin B, precum i la 5 Fluorocitoz-
in
Concluzii: C. albicans reprezint specia fungic cea mai frecvent izolat n rndul pacienilor
investigai. Majoritatea tulpinilor de C. albicans au fost rezistente la Amphotericin B, precum i la 5
Fluorocitozin. Ambele sisteme de identificare utilizate au fost la fel de performante, dar performana
testelor de sensibilitate a fost mai bun pe galeriile Candifast dect prin metoda difuzimetric clasic
P8. The prevalence of indoor fungi from residences of adult patients with or
without allergy history
Moldovan Roxana1,2, Licker Monica1,2, Stanoiev J.2, Admu Marcela1, Berceanu Vduva
Delia1, Crciunescu Mihaela1, Muntean Delia1, Rdulescu Matilda1, Blceanu Alina1,
Panaitescu Carmen1
1. University of Medicine and Pharmacy Timioara; 2. Institute of Public Health Timioara
Aim: The study is part of PNII- 41-011/2007 project and has as objective the identification of in-
door fungi from a group of adult alergic patients comparatively with a group of non-alergic adult pa-
tients residences, over a period of one year (January 1st 2008 - January 31st 2009).
Methods: We evaluated by clinical, functional and microbiological point of view a group of 36
adult alergic patients with asthma and/or alergic rhinitis, selected by the medical staff of the Alergo-
logy department of Infectious Diseases Clinical Hospital Victor Babe Timioara) according to
GINA (Global Initiative for Asthma) guidelines for asthma and ARIA (Allergic Rhinitis and its Impact
on Asthma) guidelines for rhinitis. We have also considered a group of 15 non-allergic patients. We
have collected air samples from all the 51 peoples residences, in view of indoor fungi identification.
We used M.A.Q.S (Microbiological air quality sampler - Oxoid) analyzer and Sabouraud
Chloramphenicol agar (Bio-rad). After an incubation for 48-72 h (at most 4-5 days), at 37C, fungi
identification was confirmed by microscopical examination from culture.
Results: From the total number of 134 samples provided from all those 36 alergic patients resid-
ences, 75 (from 22 residences) were positive. In the control group, 36 samples (12 residences) from a
total number of 70 colected samples were positive.
Conclusions: The percentage of residences where fungi have been isolated is similar in both
groups. The predominant strains have been represented by Aspergillus spp. (A. flavus, A. niger, A.
fumigatus).
Prevalenta fungilor interiori din locuinele subiecilor aduli cu sau fr

istoric de alergie
Moldovan Roxana1,2, Licker Monica1,2, Stanoiev J.2, Admu Marcela1, Berceanu Vduva
Delia1, Crciunescu Mihaela1, Muntean Delia1, Rdulescu Matilda1, Blceanu Alina1,
Panaitescu Carmen1
1.Universitatea de Medicin i Farmacie Timioara; 2. Institutul de Sntate Public
Timioara
Obiective: Studiul face parte din proiectul PNII- Nr. 41-011/2007 i are ca obiectiv identificarea
fungilor indoor din locuinele pacienilor aduli alergici, comparativ cu un lot de aduli nealergici, pe o
perioad de un an (1 ianuarie2008 - 31 ianuarie 2009).
Material i metod: A fost evaluat clinico-functional i microbiologic un eantion format din 36
pacieni alergici aduli cu astm bronsic i/sau rinit alergic, selectionai de ctre colectivul serviciului
de alergologie din cadrul Spitalului Clinic de Boli Infecioase i Pneumoftiziologie Victor Babe
Timioara, pe baza criteriilor impuse de ghidurile internaionale GINA (Global Initiative for Asthma)
pentru astm i ARIA (Allergic Rhinitis and its Impact on Asthma) pentru rinita alergic. De asemenea
a fost constituit un eantion martor de 15 persoane nealergice. S-au recoltat probe de aeroflor din
locuinele tuturor celor 51 persoane pentru izolarea fungilor indoor. Am utilizat n acest scop mediul de
cultur Sabouraud Chloramphenicol agar (Bio-rad) i analizorul M.A.Q.S (Microbiological air quality
sampler - Oxoid). Dup incubarea la 37C, timp de 48-72 h (pn la 4-5 zile), identificarea fungilor
provenii din aerosoli a fost confirmat prin examen microscopic din cultur, pe preparate lam-lamel.
Rezultate: Din totalul de 134 probe provenite din locuinele celor 36 pacieni alergici, 75
(provenite din 22 locuine) au fost pozitive. n eantionul martor s-au pozitivat 36 probe (din 12
locuine) dintr-un total de 70 recoltate.
Concluzii: Procentul locuinelor din care s-au izolat mucegaiuri este asemntor n cele dou
eantioane. n ambele loturi au predominat tulpinile de Aspergillus spp. n defavoarea altor genuri (A.
flavus, A. niger, A. fumigatus).
P9. Enterococcus cecorum septicemia at a patient with liver cirrhosis

Olteanu C., Marin Carmen, Elefterescu Mrioara, Todor Mihaela
Academic Emergency Hospital Sibiu
Enterococcus cecorum, one of the 30 species of the genus Enterococcus, was first described in
1983 as Streptococcus cecorum. Since then, it has been identified as part of the intestinal floras of vari-
ous animals. In contrast to the common presence of E. cecorum innimals, human infections associated
with E. cecorum have been rarely reported, with only four cases described in the English literature
(1996 to 2003).
Phenotypically, E.cecorum is often described as more Streptococcus - like than other Enterococ-
cus species, meaning it prefers incubation in atmospheric conditions with CO2 enrichment, fails to
grow on Enterococcus-selective medium and in 6.5% NaCl, and grows poorly on bile-esculin agar.
In the four cases of human infections, the isolates were identified by whole-cell protein analysis,
cellular fatty acid analysis, 16S rRNA gene sequencing, and/or tRNA gene PCR and capillary electro-
phoresis in addition to the use of conventional phenotypic tests.
In this article, we describe the case of a 59-year-old man with a long history of alcohol abuse,
liver cirrhosis with parenchymal and vascular decompensation, which seems to be a major underlying
disease predisposing patients to E. cecorum infections. Two blood cultures (aerobic and anaerobic,
Bactec-Becton Dickinson type ) were collected in the Emergency Room, which later revealed the pres-
ence of E. cecorum. Blood culture isolate was a gram-positive, non-spore-forming coccus arranged in
chains.
In the identification process, the Vitek 2 Compact System was used, with Gram-positive cards
(GP). Antimicrobial susceptibility testing (on 554 AST Gram-positive cards) could not be validated
precisely because of the phenotypicall similarity with Streptococcus more than other Enterococcus spe-
cies. It is also known that Vitek 2 Compact System performs antimicrobial susceptibility testing only
for Streptococcus agalactiae.
Therefore, the patient received an empirical treatment with Ciprofloxacin.
For typification, the blood cultures were sent to The Streptococcus, Enterococcus and Meningo-
coccus National Reference Center, Cantacuzino I.N.C.D.M.I. Bucharest.
Septicemia cu Enterococcus cecorum la un pacient cu ciroz hepatic

Olteanu C., Marin Carmen, Elefterescu Mrioara, Todor Mihaela
Spitalul Clinic Judeean de Urgen Sibiu
Enterococcus cecorum, una din cele 30 de specii din genul Enterococcus, a fost prima dat
descris in 1983 ca i Streptococcus cecorum. De atunci, a fost descris ca i component al florei
intestinale la diverse animale. In contrast cu prezena comun a Enterococcus cecorum la animale,
infeciile umane cu acest microorganism au fost rar raportate, cu doar 4 cazuri descrise in literatura
englez de specialitate (1996-2003).
Din punct de vedere fenotipic, Enterococcus cecorum a fost adesea descris ca fiind mai degrab
asemntor cu specii de Streptococcus, dect cu cele de Enterococcus, pentru c: prefer incubaia in
atmosfer imbogit cu 5% CO2 , nu crete pe medii selective pentru enterococi i pe medii cu 6,5 %
NaCl i crete slab pe bil-esculin-agar.
In cele patru cazuri, microorganismul a fost identificat pe baza analizei proteinelor celulare, an-
aliza acizilor grai celulari, analiza secvenial a 16SrARN i/sau reacia de polimerizare in lan a
tARN i electroforeza capilar, complementar folosirii testelor fenotipice convenionale.
Lucrarea abordeaz cazul unui brbat de 59 ani cu istoric indelungat de abuz de alcool, ciroz
hepatic decompensat vascular i parenchimatos, care pare a fi afeciunea major predispozant
pentru infecia cu Enterococcus cecorum. S-au recoltat dou hemoculturi (aerobic i anaerobic) tip
Bactec-Becton Dickinson in unitatea de primiri urgene, din care ulterior s-a izolat i identificat
Enterococcus cecorum. Hemoculturile au artat coci Gram pozitivi, nesporulai, dispusi n lanuri.
Pentru identificare s-a folosit sistemul automat Vitek 2 Compact, carduri pentru Gram pozitivi
(GP). Antibiograma pe card AST 554 pentru Gram pozitivi, nu a putut fi validat tocmai datorit
asemnrii fenotipice cu Streptococul, dect cu alte specii de enterococ, tiut fiind faptul c analizorul
Vitek 2 Compact nu efectueaz antibiograme dect pentru specia de Streptococcus agalactiae. Aadar,
bolnavul a fost tratat empiric cu ciprofloxacin.
Pentru tipizare flacoanele de hemocultur au fost trimise la I.N.C.D.M.I. Cantacuzino Bu-
cureti, Centrul Naional de Referin pentru Streptococi, Enterococi i Meningococi.
P10. Etiological aspects regarding infectious complications after aortic valve

replacement
Rada Maria, Velimirovici Dana, Berceanu Vduva Delia, Drgan Simona, Berceanu
Vduva M., Cobzariu I.F., Rdulescu Matilda, Arambaa Alexandra, Manca Silvia
University of Medicine and Pharmacy Victor Babe Timioara
Objectives: to establish the occurrence of germs involved in the early infectious complications
in the valvular patients after aortic valve replacement with mechanical or biological valve prosthesis.
Material and method: the study included 76 postoperative valvular patients (44 men and 32
women) from the Cardiovascular Rehabilitation Clinic Timisoara, after two weeks from the aortic
valve replacement. The average age of the patients was 627, with a predominant degenerative eti-
ology (53,94%).
Results and discussion: infectious complications were present in 15,78% of the patients, the
most frequent being respiratory, 33,33% (especially in the patients with preexistent respiratory patho-
logy), and also wound infections (33,33%), followed by urinary tract infections. Staphylococcus aure-
us was the main germ involved in the etiology of the respiratory, ENT and wound infections (50%).
Other Gram-positive cocci were also isolated - Streptococcus pneumoniae (8.33%) and Streptococcus
pyogenes (8.33%), etiology factors of respiratory infections. From the gram-negative germs, enterobac-
teria (Escherichia coli and Proteus mirabilis) were isolated in the urinary tract infections, and Pseudo-
monas aeruginosa was isolated in wound infections. E. coli was the main germ in the etiology of urin-
ary infections (16,66%).
Conclusions: infectious complications are rather frequent in the early postoperative phase, espe-
cially in debilitated patients (elderly, diabetics, obese), and their presence influenced the short-term
result of rehabilitation. The most frequent etiological agent involved in their occurrence was Staphylo-
coccus aureus, piogenic bacteria capable of producing infections in various parts of the body.
Aspecte etiologice privind complicaiile infecioase post-nlocuire valvular

aortic
Rada Maria, Velimirovici Dana, Berceanu Vduva Delia, Drgan Simona, Berceanu
Vduva M., Cobzariu I.F., Rdulescu Matilda, Arambaa Alexandra, Manca Silvia
Universitatea de Medicin i Farmacie Victor Babe Timioara
Scopul lucrrii: a fost s se stabileasc incidena germenilor implicai n apariia complicaiilor
infecioase precoce, la pacienii valvulari post-nlocuire valvular aortic cu proteze valvulare
mecanice sau biologice.
Material i metod: au fost inclui n studiu un numr de 76 pacieni valvulari operai (44
brbai i 32 femei) internai n Clinica de Recuperare Cardiovascular Timioara, n medie la dou
sptmni post-nlocuire valvular aortic. Vrsta medie a pacienilor a fost de 62 7 ani, predomin-
nd etiologia degenerativ (53.94%).
Rezultate i discuii: complicaiile infecioase au fost prezente la 15.78% din pacieni, cele mai
frecvente fiind cele respiratorii 33.33% (predominant la cei cu patologie respiratorie preexistent), pre-
cum i cele de plag (33.33%), urmate de infeciile tractului urinar. Staphylococcus aureus a fost prin-
cipalul germen implicat n etiologia infeciilor respiratorii, ORL, precum i a infeciilor de plag
(50%). S-au mai izolat i ali coci gram-pozitivi - Streptococcus pneumoniae (8.33%) i Streptococcus
pyogenes (8.33%), factori etiologici ai infeciilor respiratorii. Dintre germenii gram-negativi, en-
terobacteriile (Escherichia coli i Proteus mirabilis) s-au izolat din infeciile de tract urinar, iar bacilul
piocianic (Pseudomonas aeruginosa) a fost izolat din infeciile de plag. E. coli a fost principalul ger-
men ntlnit n etiologia infeciilor urinare (16,66%).
Concluzii: complicaiile infecioase sunt relativ frecvent ntlnite n faza postoperatorie precoce,
n special la persoanele tarate (btrni, diabetici, obezi), iar prezena acestora a influenat rezultatul pe
termen scurt al recuperrii. Cel mai frecvent agent etiologic implicat n apariia acestora a fost Staphyl-
ococcus aureus, bacterie piogen capabil de a produce infecii cu diverse localizri n organism.
P11. Incidena infestaiei cu Giardia lamblia i corelaii cu tabloul sanguin

Zdrnc Mihaela1, Mo Ioana, Drgan Ana-Maria
1. Facultatea de Medicin i Farmacie Oradea Catedra Farmacologie; 2. Facultatea de
Medicin i Farmacie Oradea Catedra Microbiologie Histologie
Introducere: Giardia lamblia este un protozoar care produce giardioz, boal cu o frecven
ridicat att n rndurile populaiei infantile ct i ale celei adulte. Boala se transmite prin chisturi, prin
ap, alimente contaminate sau interpersonal. Diagnosticul corect presupune o bun cunoatere a sem-
nelor clinice i a datelor de laborator.
Obiective: n aceast lucrare s-a studiat incidena infestaiei cu Giardia lamblia la un numr de
667 copii cu vrste cuprinse ntre 1 - 18 ani internai la Spitalul Clinic de Neurologie i Psihiatrie
Oradea, n perioada iunie 2007 - iulie 2008. S-a urmrit deasemenea prezena eozinofiliei, anemiei,
creterea vitezei de sedimentare a hematiilor i stabilirea unei corelaii ntre aceastea i infestaia cu
Giardia lamblia. Au fost exclui cei care prezentau sindroame alergice, afeciuni inflamatorii acute i
sindroame anemice de etiologie cunoscut.
Material i metod: S-au efectuat hemoleucograme cu analizorul automat Pentra 60, examenul
coproparazitologic cu soluie lugol i s-a determinat viteza de sedimentare a hematiilor prin metoda
Westergreen.
Rezultate: Studiul a evideniat un numr de 146 de copii infestai dintre care un procent de 37%
(54 cazuri) au prezentat eozinofilie, 6,84% (10 copii cu vrste ntre 15-18 ani) au prezentat limfocitoz,
iar viteza de sedimentare a hematiilor a fost crescut n 32,9% din cazuri (48 de copii). Anemia (Hb
mai mic de 11 g/dl) a fost ntlnit n 15,1 % din cazuri (22 copii).
Concluzii: Eozinofilia din lambliaz este una dintre cele mai controversate probleme. Unii
autori confirm existena eozinofiliei n cursul lambliazei, dar pentru alii protozoarele patogene
(printre care i Giardia lamblia) nu produc eozinofilie. Studiul nostru a evideniat prezena eozinofiliei
la un procent de copii infestai cu Giardia lamblia care nu prezentau alte afeciuni posibil corelate cu
eozinofilie.
The incidence of giardiasis and correlation with blood cells parameters

Zdrnc Mihaela1, Mo Ioana, Drgan Ana-Maria
1.Faculty of Medicine and Pharmacy Oradea, Pharmacology Department; 2. Faculty of
Medicine and Pharmacy Oradea, Microbiology-Histology Department
Introduction: Giardia lamblia is a protozoan parasite that causes giardiasis, a disease with high
frequency in infants as well as adults. The disease is transmitted by cysts in water, contaminated food
or interpersonal. A correct diagnosis requires a good knowledge of clinical signs and laboratory data.
Aims: In this study we analyzed the incidence of Giardia lamblia infestation in a number of 667
children aged 1-18 years hospitalized at the Clinical Hospital of Neurology and Psychiatry Oradea,
during June 2007 - July 2008. Eosinophilia, anemia, increased sedimentation rate of red blood cells and
correlation between these modified parameters with Giardia lamblia infestation was monitored. Pa-
tients with allergic syndromes, inflammatory diseases and syndromes, acute anemia of unknown eti-
ology were excluded.
Material and method: Full blood counts were determined using the hematological analyzer
Pentra 60, microscopic examination of the stool was performed with lugol solution and the rate of sedi-
mentation of red blood cells was determined by Westergreen method.
Results: Study results showed a total of 146 infested children, out of which a percentage of 37%
(54 cases) had eosinophilia, 6.84% (10 children aged 15-18 years) had limfocytosis and sedimentation
rate of red blood cells was increased in 32.9% of cases (48 children). Anemia (hemoglobin less than 11
g/dl) was seen in 15.1% of cases (22 children).
Conclusions: Eosinophilia is one of the most controversial issues. Some authors confirm the ex-
istence of eosinophilia during lambliasis, but according to others pathogenic protozoa, including Giar-
dia lamblia, do not cause eosinophilia. Our study revealed the presence of eosinophilia in children in-
fested with Giardia lamblia, which had no other illnesses possibly linked to eosinophilia.
Posters 2. Microbiology
P12. Antimicrobial resistance of nonfermentative Gram-negative bacilli
isolated from clinical specimens
Dorobat Olga Mihaela, Badicut I., Talapan D., Tenea C., Rafila A., Botea S., Popoiu M.
National Institute of Infectious Diseases Prof. Dr. Matei Bal
Objectives: To evaluate the resistance of nonfermentative Gram-negative bacilli.
Methods: A total of 295 non-duplicated strains: 159 Pseudomonas aeruginosa, 101 Acinetobac-
ter baumannii, 23 Stenotrophomonas maltophilia, 12 Achromobacter xylosoxidans isolated in 2008
were tested for antimicrobial susceptibility in automatic systems Vitek 2 C, MicroScan and with Etest,
according with CLSI 2008. Etest for the screening of MBL producers was used for P. aeruginosa.
Results: P. aeruginosa showed resistance for almost all antibiotics: impenem 35%, meropenem
and aztreonam 37%, piperacillin/tazobactam 38%, amikacin 40%, ceftazidime and tobramycin 47%,
cefepime 48%, gentamicin 52%. For ciprofloxacin and levofloxacin resistance rate was 55% respect-
ively 49%. Only 1.8% was resistant to colistin. The isolates from blood, pleural fluid and catheter,
from ICU were more resistant: 87% to imipenem, meropenem, ceftazidime, amikacin and tobramicin
and all the isolates were resistant to cefepime, gentamicin and quinolones. Etest detected phenotypicaly
MBL producer P. aeruginosa for 54% from 35 strains. Resistance of A.baumannii was: tobramycin
23%, tetracycline 54%, ampicillin/sulbactam 67%. For other antibiotics resistance rate was higher than
68%. There was no A. baumannii strain resistant to colistin. Clinical isolates from ICU were more res-
istant for the majority of the antibiotics, with differences up to 40%. S. maltophilia was resistant 8% to
trimethoprim/sulfamethoxazol and levofloxacin and 30% to tetracycline. All strains A. xylosoxidans
were resistant to gentamicin, tobramycin and aztreonam.
Conclusions: Relatively high level of resistance was observed for all nonfermentative Gram-
negative bacteria. For P. aeruginosa and A. baumannii only colistin is with low resistance. Continued
antimicrobial resistance surveillance and infection control measure should be taking to minimize the
emergence and spread of resistance.
Rezistena la antibiotice a bacililor Gram-negativi izolai din prelevate

clinice
Dorob Olga Mihaela, Bdicu I., Tlpan D., Tenea C., Rafila A., Botea S., Popoiu M.
Institutul Naional de Boli Infecioase Prof. Dr. Matei Bal
Obiectiv: Evaluarea rezistenei bacililor Gram-negativi nefermentativi.
Metode: Au fost testate 295 tulpini izolate n 2008: 159 Pseudomonas aeruginosa, 101 Acineto-
bacter baumannii, 23 Stenotrophomonas maltophilia, 12 Achromobacter xylosoxidans pentru rezistena
la antibiotice n sistemele automate Vitek 2 C, MicroScan i cu Etest, conform CLSI 2008. S-au utilizat
benzi Etest pentru screeningul P. aeruginosa productor de MBL.
Rezultate: P. aeruginosa a fost rezistent la aproape toate antibioticele: impenem 35%,
meropenem i aztreonam 37%, piperacilin/tazobactam 38%, amikacin 40%, ceftazidim i to-
bramicin 47%, cefepim 48%, gentamicin 52%. Pentru ciprofloxacin i levofloxacin rezistena a
fost 55% respectiv 49%. Numai 1,8% P. aeruginosa este rezistent la colistin. Izolatele din hemoculturi,
lichid pleural i cateter, din ATI au fost mai rezistente: 87% la imipenem, meropenem, ceftazidim, ami-
kacin i tobramicin; toate izolatele au fost rezistente la cefepim, gentamicin i quinolone. Au fost
decelate fenotipic 54% P. aeruginosa productoare de MBL din 35 testate. Rezistena A. baumannii a
fost: tobramicin 23%, tetraciclin 54%, ampicilin/sulbactam 67%. Pentru celelate antibiotice
rezistena a fost mai mare de 68%. Nu s-a decelat rezisten la colistin pentru A. baumannii. Tulpinile
izolate din ATI sunt mult mai rezistente la majoritatea antibioticelor, cu o diferen pn la 40%. S.
maltophilia a fost rezistent 8% la trimethoprim/sulfamethoxazol i levofloxacin, 30% la tetraciclin.
Toate tulpinile de A.xylosoxidans sunt rezistente la gentamicin, tobramicin i aztreonam.
Concluzii: S-a observat un nivel relativ ridicat a rezistenei la bacteriile Gram-negative nefer-
mentative. Pentru P. aeruginosa i A. baumannii numai la colistin rezistena este sczut. Pentru a re-
duce posibilitile de emergen i rspndire a rezistenei este necesar o supraveghere continu i
msuri de control.
P13. The antibiotic resistance of Pseudomonas aeruginosa strains isolated

from nosocomial infections
Admu Marcela, Licker Monica, Dragomirescu Liliana, Muntean Delia, Berceanu
Vduva Delia, Popa Mihaela, Pilu Ciprian, Prvan Ramona, Rdulescu Matilda,
Modovan Roxana
Microbiology Department, University of Medicine and Pharmacy Victor Babe Timioara
The aim of the study was to determine the antibiotic resistance of Pseudomonas aeruginosa
strains isolated from nosocomial infections.
In a period of one year (January-December 2008) we collected 8440 samples from patients hos-
pitalized in Clinical Emergency County Hospital Timioara.
Identification of the germs was performed by the API system (BioMerieux) and susceptibility
tests were performed by disk-diffusion test (CLSI standards). For detecting the antibiotic resistance we
used ticarcillin, ticarcillin/clavulanic acid, piperacillin, piperacillin/tazobactam, ceftazidime, cefepime,
aztreonam, imipenem, gentamicin, tobramycin, netilmicin, amikacin, norfloxacin, pefloxacin, levo-
floxacin and ciprofloxacin.
From 8440 samples we isolated 130 Pseudomonas aeruginosa strains, from which 24 were
ESBL producing strains. The percentage of quinolone and aminoglycosides resistant isolates was
43.84% for quinolones and 60% for aminoglycosides. We observed the maintenance of natural sensib-
ility to all antibiotics in 25.38% (33 strains) from all the strains we have studied.
The high prevalence of antibiotic resistance Pseudomonas aeruginosa strains is explained by
prolonged antibiotic therapy of patients with invasive diagnostic and therapeutic procedures.
Rezistena la chimioterapice antiinfecioase a tulpinilor de Pseudomonas

aeruginosa izolate din infecii nosocomiale
Admu Marcela, Licker Monica, Dragomirescu Liliana, Muntean Delia, Berceanu
Vduva Delia, Popa Mihaela, Pilu Ciprian, Prvan Ramona, Rdulescu Matilda,
Modovan Roxana
Disciplina de Microbiologie, Universitatea de Medicin i Farmacie "Victor Babe"
Timioara
Scopul acestui studiu a fost determinarea rezistenei la antibiotice a tulpinilor de Pseudomonas
aeruginosa izolate din infecii nosocomiale.
Timp de un an (ianuarie - decembrie 2008) am prelevat 8440 produse patologice de la pacieni
internai la Spitalul Clinic de Urgen Judeean Timioara.
Identificarea germenilor s-a realizat cu ajutorul sistemului API (BioMerieux) i testarea sensibil-
itii germenilor la chimioterapice antiinfecioase prin metoda difuzimetric (conform standardelor
CLSI).
Pentru determinarea rezistenei la antibiotice am utilizat: ticarcilin, ticarcilin/ac. clavulanic,
piperacilin, piperacilin/tazobactam, ceftazidim, cefepim, aztreonam, imipenem, gentamicin, to-
bramicin, netilmicin, amikacin, norfloxacin, pefloxacin, levofloxacin, ciprofloxacin.
Din 8440 produse patologice am izolat 130 tulpini de Pseudomonas aeruginosa, dintre acestea
24 au fost productoare de BLSE.
Procentul tulpinilor rezistente la quinolone i aminoglicozide a fost 43,84% pentru quinolone i
60% pentru aminoglicozide.
Am observat meninerea sensibilitii naturale, pentru toate antibioticele testate, la 25,38% (33
tulpini) din tulpinile studiate.
Procentul mare de tulpini de Pseudomonas aeruginosa rezistente la antibiotice poate fi explicat
prin terapia de lung durat cu antibiotice a pacienilor supui procedurilor invazive efectuate n scop
diagnostic i terapeutic.
P14. Acquired resistance phenotypes of Klebsiella spp. isolated from

newborn and premature units
Crciunescu Mihaela, Licker Monica, Popa Mihaela, Berceanu-Vduva Delia,
Dugeescu Dorina, Hogea Elena, Muntean Delia, Horhat F., Pilu C., Moldovan Roxana
Microbiology Department, University of Medicine and Pharmacy Victor Babe Timioara
In the period 01.12.2008 31.02.2009, there were harvested 724 bacteriological samples from
new born and premature, hospitalized in "Dr. Dumitru Popescu" Hospital Timioara. From the 724
probes harvested we isolated a number of 384 bacteria strains with nosocomial potential and the rest
were sterile (142 from new-born and 192 from premature). The identification was made in Clinical Mi-
crobiology Laboratory of the Hospital mentioned above. Antimicrobial susceptibility test were made
using both: disk diffusion (Kirby-Bauer method) and agar dilution tests (API TEST). From the 385
bacterial strains with nosocomial potential we isolated a number of 92 Klebsiella spp., from which 18
were isolated from new-born, and the rest of 74 strains of Klebsiella spp. from the premature unit.
From the 18 Klebsiella spp. isolated in newborn: 13 strains were represented by Klebsiella pneumoniae
and 5 by Klebsiella oxytoca. From 74 strains of Klebsiella spp. isolated in premature, 60 strains are
Klebsiella pneumoniae and 14 strains are Klebsiella oxytoca. The sensibility of Klebsiella spp. was
tested using the methods above mentionated with the purpose of framing the strains in resistance phen-
otypes. From the 92 strains of Klebiella spp. 42 was Klebsiella pneumoniae presenting ESBL pheno-
type, associated with aminoglycosides resistance. We have also identified 5 strains of Klebsiella oxy-
toca with PASE resistance phenotype associated with trimethoprim-sulphamethoxazol resistance.
Fenotipuri de rezisten ale tulpinilor de Klebsiella spp. izolate ntr-o secie

de nou nscui i prematuri
Crciunescu Mihaela, Licker Monica, Popa Mihaela, Berceanu-Vduva Delia,
Dugeescu Dorina, Hogea Elena, Muntean Delia, Horhat F., Pilu C., Moldovan Roxana
Disciplina de Microbiologie, Universitatea de Medicin i Farmacie "Victor Babe"
Timioara
n perioada 01.12. 2008 31.02.2009 au fost recoltate 724 produse patologice de la nou nscui
i prematuri spitalizai n Clinica Dr. Dumitru Popescu din Timioara. Din cele 724 de probe am
izolat 384 tulpini bacteriene cu potenial nosocomial, restul probelor au fost sterile (142 probe din
secia de nou nscui i 192 din secia prematuri). Identificarea i testarea sensibilitii la chimioter-
apice s-a efectuat n laboratorul de bacteriologie al spitalului. Antibiograma s-a efectuat att prin met-
oda difuzimetric Kirby-Bauer ct i prin metoda diluiilor folosind galeriile API TEST. Din cele 385
de tulpini cu potenial nosocomial, 92 au fost Klebsiella spp., din care 18 tulpini din secia de nou-ns-
cui, iar restul de 74 tulpini din secia de prematuri. Din cele 18 tulpini Klebsiella spp., izolate n secia
de nou-nscuti 13 tulpini au fost Klebsiella pneumoniae i 5 Klebsiella oxytoca. n secia de prematuri
au fost izolate 74 tulpini, din care 60 au fost reprezentate de Klebsiella pneumoniae, iar 14, de Klebsi-
ella oxytoca. n urma testrii sensibilitii prin metodele menionate anterior, tulpinile de Klebsiella
spp. au fost ncadrate n fenotipuri de rezisten. Din cele 92 tulpini de Klebsiella spp., 42 au fost Kleb-
siella pneumoniae ncadrate n fenotipul productor de BLSE asociat cu rezisten la aminoglicozide.
Au fost identificate i 5 tulpini de Klebsiella oxytoca productoare de penicilinaz care au asociat
rezisten la trimetoprim-sulfametoxazol.
P15. Antibiotic resistance of strains isolated from ear secretions

Popa Daniela 1, Micle Otilia1, Apati Estera2, Mortan Ramona 2, Marusca Patricia1,
Negrean Rodica1
1. Faculty of Medicine and Pharmacy of Oradea; 2. Bioclinica Laboratory of Oradea
The aim of this study was to establish the microbial etiology of external otitis and to determine
the degree of resistance to antibiotics of these germs.
Material and methods. The study included 78 ear secretions collected in outpatients from 1 to
42 years, by ENT specialists and sent to the laboratory to specify microbial etiology. Samples were in-
oculated on the following media: blood-agar, AABTL, Chapman, Sabouraud. In positive cultures spe-
cific biochemical tests had been performed, in the end undergoing antibiotic and antifungal tests
through the Kirby-Bauer disc diffusion method.
Results. Of all examined ear secretions, 69,23% were positive (54 cases), 48 of these cases had
bacterial etiology, and in 6 cases fungi were involved. The main pathogens isolated were Staphylococ-
cus aureus in 17 cases (35,41%) and Pseudomonas aeruginosa in 12 cases (25%). Other bacterial spe-
cies involved in external otitis were: Proteus mirabilis, coagulase-negative staphylococci, streptococci
in 3 cases each (6,25%); Klebsiella pneumoniae and other Gram negative rods in 2 cases each (4,16%).
In the remaining 6 cases (12,5%) multibacterial etiology was identified.
Resistance of Staphylococcus aureus to penicillin 88,32% and erythromycin 64,70% was high,
for coagulase-negative staphylococci to penicillin and clindamycin was also increased (66,66% each).
Staphylococci had been found to be highly sensitive to oxacillin 94,11% and ciprofloxacin 88,23%, all
staphylococcus strains were susceptible to vancomycin. Pseudomonas aeruginosa strains showed res-
istance to trimethoprim-sulfametoxazol over 80% and Proteus mirabilis strains, over 60%, to tetracyc-
lin and imipenem.
Conclusions. Microbial external otitis in children and young adults had, in most cases,
monobacterial etiology. The main microbial agent involved was Staphylococcus aureus, closely fol-
lowed by Pseudomonas aeruginosa.
Spectrul de rezisten a bacteriilor izolate din secreii otice

Popa Daniela1, Micle Otilia1, Apati Estera2, Mortan Ramona 2, Marusca Patricia1,
Negrean Rodica1
1. Facultatea de Medicin i Farmacie din Oradea; 2. Laboratorul Bioclinica din Oradea
Obiectivul acestui studiu este stabilirea etiologiei microbiene a otitelor externe, precum i de-
terminarea gradului de rezisten a acestor bacterii la antibiotice.
Material i metode. Studiul cuprinde 78 de secreii otice recoltate la pacieni din ambulator, cu
vrsta ntre 1 i 42 de ani, de ctre medicul specialist ORL i trimise la laborator pentru precizarea eti-
ologiei microbiene. Probele au fost nsmnate pe urmtoarele medii de cultur: geloz-snge,
AABTL, Chapman i Sabouraud. Pentru culturile pozitive au fost efectuate teste biochimice specifice,
n vederea identificrii germenilor, n final efectundu-se antibiograma, respectiv antifungigrama, prin
metoda difuzimetric Kirby-Bauer.
Rezultate. Din totalul secreiilor otice examinate, 69,23% au fost pozitive (54 cazuri), dintre
care 48 de cazuri de etiologie bacterian i 6 cazuri de etiologie micotic. Principalii ageni patogeni
izolai au fost: Staphylococcus aureus n 17 cazuri (35,41%) i Pseudomonas aeruginosa n 12 cazuri
(25%). Alte specii bacteriene implicate n producerea otitelor externe au fost: Proteus mirabilis, stafilo-
coci coagulazo-negativi, streptococi n 3 cazuri fiecare (6,25%), precum i Klebsiella pneumoniae i
ali bacili Gram-negativi n 2 cazuri fiecare (4,16%). n restul de 6 cazuri (12,5%) s-a evideniat etiolo-
gia pluribacterian.
Rezistena tulpinilor de Staphylococcus aureus este crescut la penicilin 88,23% i eritromicin
64,70% , iar a tulpinilor de stafilococi coagulazo-negativi, la penicilin i clindamicin 66,66% fiecare.
S-a constatat sensibilitatea crescut a stafilococilor la oxacilin 94,11% i ciprofloxacin 88,23%, toate
tulpinile de stafilococi au fost sensibile la vancomicin. Tulpinile de Pseudomonas aeruginosa prezint
rezisten de peste 80% la trimetoprim-sulfametoxazol, iar cele de Proteus mirabilis, de peste 60%, la
tetraciclin i imipenem.
Concluzii. Otitele externe microbiene la copil i adultul tnr sunt n majoritatea cazurilor de
etiologie monobacterian. Principalul agent etiologic implicat este Staphylococcus aureus, urmat n-
deaproape de Pseudomonas aeruginosa.
P16. The study of acquired antimicrobial resistance of some uropathogens

Popa Mihaela, Licker Monica, Muntean Delia, Berceanu Vduva Delia, Crciunescu
Mihaela, Hogea Elena, Admu Marcela, Rdulescu Matilda, erban D., Moldovan
Roxana
Microbiology Department - University of Medicine and Pharmacy Victor Babe Timioara
Background: The urinary tract is one of the most frequent sites where the bacterial infections
are localized. These infections occur at every age and more often among women. According to
Roberts, 10-15 % of women deal with these urinary tract infections (UTI) at least once in their lifetime,
6 % of the adult women develop UTI every year.
Methods: 94 bacterial strains have been studied, taken from 400 urocultures, collected from
hospitalized patients (Urology Department of Timisoara County Hospital) and outpatients. Identific-
ation (API system) and sensitivity tests have been performed at the UMFTs Microbiology Laboratory.
Results: The Urology Department results are the following: 176 from 239 urocultures have been
sterile, the rest of them being positive, with 63 isolated bacterial strains. A preponderence of E. coli
and Klebsiella pneumoniae strains has been noticed.
For E. coli strains we identified the following phenotypes: susceptible 4.16%, trimethoprim-
sulfamethoxazol resistant (SXT) 8.33%, penicilinase producing strains with associated SXT resistance
29.16%, extended-spectrum beta-lactamases producers associated with aminoglycoside, fluoroquino-
lone and SXT resistance 33.33%, fluoroquinolone resistant 8.33%, penicilinase producers associated
with fluoroquinolone and SXT resistance 4.16%, penicilinase producers associated with fluoroquino-
lone resistance 8.33%, penicilinase producers 4.16%.
Conclusion: The hospital strains are dangerous as they have the species highest patho-
genic characteristics and, at the same time, are multidrug resistant (MDR). In general, they are
the R factor bearing species: Pseudomonas spp., Proteus spp., Klebsiella spp. and Escherichia
coli.
Studiul rezistenei dobndite la chimioterapice antiinfecioase a unor

germeni izolai din uroculturi
Popa Mihaela, Licker Monica, Muntean Delia, Berceanu Vduva Delia, Crciunescu
Mihaela, Hogea Elena, Admu Marcela, Rdulescu Matilda, erban D., Moldovan
Roxana
Universitatea de Medicin i Farmacie "Victor Babe"Timioara-Disciplina de Microbiologie
Introducere: Tractul urinar reprezint unul dintre cele mai frecvente localizri ale infeciilor bac-
teriene, ce afecteaz toate vrstele, predominnd la sexul feminin. Roberts apreciaz c 10-15% dintre
femei sunt confruntate cu infeciile tractului urinar (ITU) cel puin o dat n via, 6% din femeile
adulte dezvolt ITU anual.
Metod: Au fost luate n studiu un numr de 94 tulpini bacteriene, izolate din 400 uroculturi
provenite de la pacieni internai n secia Urologie a Spitalului Clinic Judeean Timioara, precum i
de la pacieni din ambulator. Identificrile (cu ajutorul sistemului API) i testele de sensibilitate la
chimioterapice s-au efectuat n cadrul Laboratorului Disciplinei de Microbiologie al U.M.F. Timioara.
Rezultate: Pentru secia Urologie a Spitalului Judeean Timioara rezultatele sunt urmtoarele:
din cele 239 uroculturi efectuate 176 au fost sterile, izolndu-se 63 tulpini microbiene. S-a constatat
predominena tulpinilor de E. coli i Klebsiella pneumoniae.
Pentru tulpinile de E. coli repartiia fenotipurilor a fost urmtoarea: sensibil 4,16%, rezistent la
biseptol (SXT) 8,33%, productor de penicilinaz asociind rezisten la SXT 29,16%, productor de -
lactamaz cu spectru extins asociind rezisten la aminoglicozide, fluoroquinolone i SXT 33,33%,
rezistent la fluoroquinolone 8,33%, productor de penicilinaz, asociind rezisten la fluoroquinolone
i SXT 4,16%, productor de penicilinaz, asociind rezisten la fluoroquinolone 8,33%, productor de
penicilinaz 4,16%.
Concluzii: Tulpinile periculoase de spital sunt acelea care au patogenitatea maxim
caracteristic speciei, fiind totodat multirezistente la antibiotice. Ele aparin n general speciilor
purttoare de factor R: Pseudomonas spp., Proteus spp., Klebsiella spp. i Escherichia coli.
P17. Patterns of resistance to antibiotics of some Klebsiella pneumoniae

strains isolated from urocultures
Berceanu Vduva Delia, Muntean Delia, Licker Monica, Velimirovici Dana, Crciunescu
Mihaela, Admu Marcela, Rada Maria, Simona Drgan, erban D., Moldovan Roxana
"Victor Babe University of Medicine and Pharmacy, Timioara
Objectives: Although E. coli is the main etiological agent of urinary infections, Klebsiella pneu-
moniae is frequently isolated in urocultures. It is encountered in both uncomplicated and complicated,
recurrent infections, and also following catheterization or other instrumental manoeuvres of the urinary
tract.
We propose a comparative study of the resistance to antibiotics of Klebsiella pneumoniae strains
isolated from urocultures from ambulatory and two surgical wards (urology and obstetrics-
gynecology), and also to establish the resistance phenotypes of these strains.
Since Klebsiella spp. is first among enterobacteria regarding the production of extended spec-
trum beta-lactamase (ESBL), we studied the occurrence of ESBL strains.
Material and methods: 83 Klebsiella pneumoniae strains, isolated from 3289 urine cultures
were studied. Germ identification was performed with the API system, and testing antibiotic sensitivity
was performed through Kirby-Bauer disk-diffusion test, with automatic phenotyping (Osiris Evolution
system).
In order to highlight ESBL strains, the synergy test was also used.
Results: From 3289 urine cultures, 1100 were positive (431 - ambulatory, 462 - urology and 207
- obstetrics-gynecology). From the positive urocultures, 183 Klebsiella pneumoniae strains were isol-
ated: 36 (8.35%) in ambulatory, 119 (25.75%) in urology and 28 (13.52%) in obstetrics-gynecology.
In the strains isolated from hospital environment, the ESBL phenotype was predominant (uro-
logy 68.06%, obstetrics-gynecology 28.57%), while in the ambulatory the wild phenotype was pre-
dominant (69.44%).
Conclusions: A continuous increase of the resistance of the Klebsiella pneumoniae strains to a
series of antimicrobial agents was observed, especially in hospital environment.
Pattern-uri de rezisten la antibiotice ale unor tulpini de Klebsiella

pneumoniae izolate din uroculturi
Berceanu Vduva Delia, Muntean Delia, Licker Monica, Velimirovici Dana, Crciunescu
Mihaela, Admu Marcela, Rada Maria, Simona Drgan, erban D., Moldovan Roxana
Universitatea de Medicin i Farmacie "Victor Babe" Timioara
Obiective: Dei E. coli este principalul agent etiologic al infeciilor urinare, Klebsiella pneumo-
niae se izoleaz frecvent din uroculturi. Se ntlnete att n infeciile necomplicate, ct i n cele com-
plicate i recidivante, precum i dup cateterizri sau manevre instrumentale ale aparatului urinar.
Ne-am propus un studiu comparativ al sensibilitii la antibiotice a tulpinilor de Klebsiella pneu-
moniae izolate din uroculturi provenite din ambulator i din dou secii cu profil chirurgical (urologie
i obstetric-ginecologie) i totodat s stabilim fenotipurile de rezisten n care se ncadreaz aceste
tulpini.
Deoarece Klebsiella spp. se situeaz pe locul nti ntre eterobacterii n ceea ce privete produ-
cerea de beta-lactamaze cu spectru extins (BLSE), am studiat incidena tulpinilor BLSE.
Material i metod: S-au studiat 83 tulpini Klebsiella pneumoniae izolate din 3289 uroculturi.
Identificarea germenilor s-a realizat cu ajutorul sistemului API, iar testarea sensibilitii la antibiotice
s-a realizat prin metoda difuzimetric Kirby-Bauer, cu fenotipare automat prin sistemul Osiris Evolu-
tion.
Pentru evidenierea tulpinilor BLSE s-a utilizat i testul de sinergie.
Rezultate: Din 3289 uroculturi recoltate, 1100 au fost pozitive (431 - ambulator, 462 - urologie
i 207 - obstetric-ginecologie).
Din uroculturile pozitive au fost izolate 183 tulpini de Klebsiella pneumoniae: 36 (8,35%) din
ambulator, 119 (25,75%) din urologie i 28 (13,52%) din obstetric-ginecologie.
La tulpinile izolate din mediul spitalicesc a predominat fenotipul BLSE (urologie - 68,06%, ob-
stetric-ginecologie - 28,57%), iar n ambulator a predominat fenotipul sensibil (69,44%).
Concluzii: S-a constatat o scdere continu a sensibilitii tulpinilor de Klebsiella pneumoniae,
la o serie de ageni antimicrobieni, n special n mediul spitalicesc.
P18. Antimicrobial resistance in community acquired Escherichia coli

urinary isolates
Muntean Delia, Licker Monica, Berceanu Vduva Delia, Hogea Elena, Popa Mihaela,
Admu Marcela, Dugeescu Dorina, Zugravu Roxana, Prvan Ramona, Moldovan
Roxana
Microbiology Department - University of Medicine and Pharmacy Victor Babe Timioara
Background: E. coli is the commonest cause of acute urinary tract infection. Antibiotic treat-
ment is usually empirical, relying on susceptibility data from local surveillance studies. The aim of our
study was to determine the prevalence of E. coli strains, isolated from community acquired urinary
tract infections, and their resistance patterns, over a period of one year (January - December 2008) in
three clinical microbiology laboratories from Timioara.
Methods: Identification of germs was performed on API system and susceptibility tests by
Kirby-Bauer technique (CLSI standards). Antimicrobial susceptibility to ampicillin, amoxicillin-clavu-
lanate, cefuroxime, ceftazidime, gentamicin, ciprofloxacin, trimethoprim-sulfamethoxazol and nitro-
furantoin was determined for 1250 E. coli urinary isolates obtained from outpatients in Timioara. For
extended spectrum beta-lactamases producing germs we also used disk synergy tests (study of a syn-
ergy between an amoxicillin-clavulanate and cefotaxime, cefuroxime, ceftazidime, aztreonam).
Results: Nitrofurantoin was the most active agent (99,12% susceptible), followed by ceftazi-
dime (96,4% susceptible) and gentamicin (89,6% susceptible). High rates of resistance to ampicillin
(61,6%), trimethoprim-sulfamethoxazol (41,6%) and amoxicillin-clavulanate (34,4%) were observed in
these isolates. Production of extended spectrum beta-lactamase was observed in 3,6% of isolates.
Rezistena la antibiotice a tulpinilor de Escherichia coli izolate n infecii

urinare comunitare
Muntean Delia, Licker Monica, Berceanu Vduva Delia, Hogea Elena, Popa Mihaela,
Admu Marcela, Dugeescu Dorina, Zugravu Roxana, Prvan Ramona, Moldovan
Roxana
Universitatea de Medicin i Farmacie "Victor Babe" Timioara - Disciplina de
Microbiologie
Introducere: E. coli este microorganismul cel mai frecvent implicat n etiologia infeciilor urin-
are acute. Frecvent, n tratamentul acestor infecii sunt utilizate antibiotice prescrise empiric pe baza
rezultatelor unor studii statistice efectuate n timp, n zona geografic respectiv. n acest studiu am ur-
mrit determinarea prevalenei i rezistenei tulpinilor de E. coli izolate n infeciile urinare comunitare
n anul 2008 (ianuarie decembrie), n trei laboratoare de microbiologie clinic din Timioara.
Metod: Identificarea germenilor s-a realizat cu ajutorul sistemului API, iar testarea sensibil-
itii la antibiotice prin tehnica Kirby-Bauer conform standardului CLSI. Pentru toate cele 1250 tulpini
de E. coli izolate de la pacienii cu infecii urinare din ambulatoriu, am testat sensibilitatea la ampicil-
in, amoxicilin - acid clavulanic, cefuroxim, ceftazidim, gentamicin, ciprofloxacin, trimetoprim-
sulfametoxazol i nitrofurantoin. Pentru tulpinile secretoare de beta - lactamaze cu spectru extins am
efectuat suplimentar testul de sinergie ntre amoxicilin-acid clavulanic i cefotaxim, cefuroxim,
ceftazidim, aztreonam.
Rezultate: Nitrofurantoinul a fost chimioterapicul cel mai activ (sensibilitate 99,12%), urmat de
ceftazidim (sensibilitate 96,4%) i gentamicin (sensibilitate 89,6%). La tulpinile izolate am observat
rezisten crescut fa de ampicilin (61,6%), trimetoprim-sulfametoxazol (41,6%) i amoxicilin-acid
clavulanic (34,4%). Un procent de 3,6% din tulpini au fost confirmate pentru producerea de beta-
lactamaze cu spectru extins.
Concluzii: Procentul tulpinilor rezistente la ampicilin i trimetoprim-sulfametoxazol, princip-
alele chimioterapice utilizate n tratamentul infeciilor urinare, a fost extrem de mare, fapt ce impune
restrngerea prescrierii lor empirice.
P19. Quinolone resistant strains isolated from the intensive care unit
Muntean Delia, Licker Monica, Berceanu Vduva Delia, Crciunescu Mihaela,
Dragomirescu Liliana, Horhat F., Rdulescu Matilda, Pilu C., erban D., Moldovan
Roxana
Microbiology Department-University of Medicine and Pharmacy Victor Babe Timioara
Aims: The aim of the study was to determine the quinolone resistance of strains with nosocomi-
al potential, isolated from patients hospitalized in the Intensive Care Unit (ICU).
Methods: Identification of germs was performed by the API system (BioMerieux) and suscept-
ibility tests by disk-diffusion tests (CLSI standards). For detecting the quinolone resistance, we used
nalidixic acid, pefloxacin, norfloxacin, ofloxacin and ciprofloxacin. We categorized these strains ac-
cording to their phenotypic patterns.
Results: In our study undertaken over a period of six months (June - November 2008), from 680
samples (bronchoalveolar fluids, wound secretions, urines, blood samples, etc.) we isolated 760 micro-
bial strains with nosocomial potential, out of which 130 were E. coli, 290 Klebsiella pneumoniae, 170
S. aureus, 60 Pseudomonas aeruginosa, 40 Acinetobacter baumannii, etc. Phenotype I, with natural
sensibility maintained to quinolones was observed in 28,95% from all the strains we have studied. We
observed the predominance of IV phenotypes, with cross resistance to all quinolones (538 strains). The
percentage of quinolone resistant isolates showing resistance to two or more antibiotics was 71,05%
(540 strains: 90 E. coli, 180 Klebsiella pneumoniae, 150 S. aureus, 20 Pseudomonas aeruginosa, 30
Acinetobacter baumannii, etc).
Conclusions: The high number of quinolone resistant germs imposes a rational policy in pre-
scribing these antibiotics in hospitals.
Rezistena la quinolone a unor tulpini izolate dintr-o secie de terapie

intensiv
Muntean Delia, Licker Monica, Berceanu Vduva Delia, Crciunescu Mihaela,
Dragomirescu Liliana, Horhat F., Rdulescu Matilda, Pilu C., erban D., Moldovan
Roxana
Universitatea de Medicin i Farmacie "Victor Babe"Timioara - Disciplina de
Microbiologie
Scop: n acest studiu am urmrit determinarea rezistenei la quinolone pentru tulpinile cu po-
tenial nosocomial izolate de la pacienii unei Secii de Terapie Intensiv (ATI).
Metode: Identificarea germenilor s-a realizat cu ajutorul sistemului API, iar testarea sensibilitii
la antibiotice prin tehnica Kirby-Bauer conform standardului CLSI. Pentru determinarea fenotipurilor
de rezisten la quinolone am testat sensibilitatea la acid nalidixic, pefloxacin, norfloxacin, ofloxacin i
ciprofloxacin.
Rezultate: Timp de 6 luni (iunie - noiembrie 2008) au fost prelevate 680 de produse patologice
(aspirate bronice, secreii de plag, urini, snge, etc.) izolndu-se 760 tulpini microbiene cu potenial
nosocomial, dintre acestea 130 fiind reprezentate de E. coli, 290 Klebsiella pneumoniae, 170 S. aureus,
60 Pseudomonas aeruginosa, 40 Acinetobacter baumannii, etc. Fenotipul I, cu sensibilitatea natural
fa de quinolone pstrat, a fost ntlnit la 28,95% din tulpinile studiate. Am constatat predominena
fenotipului IV, cu rezisten ncruciat ntre toate quinolonele (538 de tulpini). Procentul tulpinilor
rezistente la dou sau mai multe din quinolonele testate a fost de 71,05% (540 tulpini: 90 E. coli, 180
Klebsiella pneumoniae, 150 S. aureus, 20 Pseudomonas aeruginosa, 30 Acinetobacter baumannii, etc).
Concluzii: Numrul ridicat de tulpini rezistente la quinolone impune o politic raional de pre-
scriere a acestor antibiotice n spitale.
P20. Preliminary study regarding multidrug resistance in germs isolated

from intensive care units
Licker Monica1,2, Muntean Delia1, Bdioiu Luminia1,2, Dragomirescu Liliana1,3, Horhat
F. 1,3, Hogea Elena1, Chicin Graiana2, Stanoiev J.2, Brnzeu Cristina3, Moldovan
Roxana1,2
1. University of Medicine and Pharmacy Victor BabesTimioara; 2. Institute of Public
Health Timioara; 3. Clinical Emergency County Hospital Timioara
Objectives: The study is part of PNII- Nr. 42121/2008 project and has as objective the
identification of multidrug resistant germs (MDR) from intensive care units (ICUs).
Methods: We have evaluated samples collected from patients hospitalized in ICUs from Tim-
ioara and Arad clinical hospitals, in the period of January-March 2009. Identification, antimicrobial
susceptibility tests and phenotyping were performed at the Microbiology Department of University of
Medicine and Pharmacy Victor Babe Timioara, using the VITEK 2 compact (BioMerieux) analyz-
er. ESBL production was also assessed by disk synergy (CLSI standards).
Results: We studied a selection of 99 bacterial strains, collected from the mentioned ICUs, out
of which 52 were included in the MDR group considered in our study: ESBL producing enterobacteria
(22 strains of E. coli, 17 Klebsiella pneumoniae, 1 Klebsiella ornithinolytica, 1 Enterobacter aero-
genes, 1 Serratia rubidaea), carbapeneme resistant Pseudomonas aeruginosa and Acinetobacter bau-
manii (4 strains) and methicillin resistant S. aureus (6 strains). These germs were isolated especially
from bronchial aspirates, urine samples and purulent secretions.
Conclusions: Multidrug resistance, as well as the continuous increase of several phenotypes
prevalence is an alarming worldwide phenomenon for modern medicine which is struggling with the
decrease of therapeutical options and the reduced discovery rate for new antimicrobials. The aim of
this project is to help the introduction of molecular models for screening and monitoring of multidrug
resistance in the South-Western part of Romania.
Studiu preliminar privind multirezistena germenilor izolai din secii de

terapie intensiv
Licker Monica1,2, Muntean Delia1, Bdioiu Luminia1,2, Dragomirescu Liliana1,3, Horhat
F. 1,3, Hogea Elena1, Chicin Graiana2, Stanoiev J.2, Brnzeu Cristina3, Moldovan
Roxana1,2
1. Universitatea de Medicina i Farmacie Victor BabeTimioara; 2. Institutul de Sntate
Public Timioara; 3. Spitalul Clinic Judeean de Urgen Timioara
Obiective: Studiul face parte din proiectul PNII- Nr. 42121/2008 i are ca obiectiv identificarea
tulpinilor bacteriene multirezistente la antibiotice (MDR) din seciile de terapie intensiv (ATI).
Material i metode: Au fost analizate produse patologice care au provenit de la pacieni in-
ternai n seciile ATI ale unor Spitale Clinice din Timioara i Arad, n perioada ianuarie-martie 2009.
Identificarea germenilor, testarea sensibilitii la chimioterapice antiinfecioase i ncadrarea ger-
menilor n fenotipuri de rezisten s-au realizat la sediul disciplinei de Microbiologie a UMF Victor
Babe Timioara, cu ajutorul analizorului VITEK 2 compact (BioMerieux). Pentru ncadrarea en-
terobacteriilor n fenotipul productor de beta-lactamaze cu spectru extins (BLSE) am efectuat i testul
sinergiei (standard CLSI).
Rezultate: Am luat n studiu o selecie de 99 tulpini izolate din seciile mai sus menionate, din
care 52 s-au ncadrat n categoria MDR avute n vedere n proiectul nostru: tulpini de enterobacterii
secretoare de BLSE (22 tulpini de E. coli, 17 Klebsiella pneumoniae, 1 Klebsiella ornithinolytica, 1
Enterobacter aerogenes, 1 Serratia rubidaea), Pseudomonas aeruginosa i Acinetobacter baumannii
rezistente la carbapeneme (4 tulpini) i S. aureus meticilino-rezistent (6 tulpini). Germenii au fost
izolai mai ales din aspirate bronice, uroculturi, secreii de plag.
Concluzii: Multirezistena bacterian, ca i prevalenele n continu cretere pentru unele feno-
tipuri, reprezint un fenomen universal, deosebit de ngrijortor pentru medicina actual, confruntat cu
diminuarea opiunilor terapeutice i cu reducerea ritmului de fabricare a unor noi antibiotice. Prin actu-
alul proiect ne propunem s contribuim la implementarea metodelor moleculare n screening-ul i mon-
itorizarea multirezistenei bacteriene n partea de Sud-Vest a Romniei.
Posters 3. Immunology
P21. Interconnection between clinical findings and HLA classes at patients
with psoriatic arthritis in Republic of Moldova
Russu Eugeniu, Babiuc Constantin, Muset Gheorghe, Sali Vera
Republic of Moldova
Objective: The aim of this study was to analyze the clinical manifestation of psoriatic arthritis
and associations with human leukocyte antigens (HLA-antigens) and to identify the markers for ag-
gressive joint disease. Method: Ninety nine patients with psoriatic arthritis with defined joint disease
were examined clinically, radiologically, and with laboratory-based analyses. The classification and the
diagnosis of the disease have been based on CASPAR criteria. Results: We have found a high preval-
ence of HLA-B7, B17, B27, B37 and HLA-A2, A3, A7 and A29 which were increased in comparison
with controls (p=0.012, pc=0.024, RRf=3.1), but the strongest predictive factors for an aggressive dis-
ease among patients with poliarthritis and axial disease of psoriatic arthritis, in a multiple logistic ana-
lysis and polifactorial correlation, were HLA-A3, A29, B27, B37; a significant linkage (p=0.0001,
RRf=2.9) was found. Conclusion: The prevalence of inflammatory joint manifestations, such as poli-
arthritis, axial disease and mutilate arthritis was high among patients with psoriatic arthritis in Republic
of Moldova. There were several strong association between HLA-antigens (B7, B17, B27, B37, A2,
A3, A7, A29) and psoriatic arthritis.The strongest predictive factors for an aggressive disease among
patients with poliarthritis and axial disease of psoriatic arthritis, were HLA-A3, A29, B27, B37 with a
significant linkage (p = 0.0001, RRf = 2.9).
Conexiunile dintre tabloul clinic al artritei psoriazice i clasele HLA la

pacienii din Republica Moldova
Russu Eugeniu, Babiuc Constantin, Muset Gheorghe, Sali Vera
Republica Moldova
Obiective: Scopul studiului a fost de a efectua identificarea markerilor agresivitii bolii prin de-
pistarea interconexiunii dintre clasele HLA i formele clinice de artrit psoriazic. Metode: au fost stu-
diai 99 pacieni cu artrit psoriazic prin examinare clinic i paraclinic. Diagnosticul a fost stabilit
pe baza criteriilor CASPAR. Rezultate: s-a depistat o prevalen nalt a HLA-B7, B17, B27, B37 i
HLA-A2, A3, A7 i A29 care au fost crescute n comparaie cu lotul de control (p=0.012, pc=0.024,
RRf=3.1), ns corelarea cea mai puternic ntre agresivitatea bolii i formele: poliarticular i axial,
ale artritei psoriazice, au prezentat determinantele HLA-A3, A29, B27, B37, pentru care s-a determinat
o legtura puternic (p=0.0001, RRf=2.9). Concluzii: Sunt mai multe locusuri de corelare puternic
ntre artrita psoriazic i clasele HLA (B7, B17, B27, B37, A2, A3, A7, A29). S-au depistat factori pre-
dictivi pentru o evoluie sever a artritei psoriazice, ce coreleaz ferm cu agresivitatea bolii, ele fiind
HLA-A3, A29, B27, B37 cu un linkage manifest (p=0.0001, RRf =2.9).
P22. Evaluation of the role of interleukin 13 in psoriatic arthritis versus

rheumatoid arthritis
Ciacli Camelia1, Gligor Ramona1, Puschita Maria1, Gurban Camelia2, Crasnic Ioan
1. Faculty of Medicine, Pharmacy and Dental Medicine, Vasile Goldi Western University,
Arad, Romania; 2. University of Medicine and Pharmacy, Timioara
Introduction: In our study we evaluated the blood and synovial liquid concentration of inter-
leukin 13 (IL-13), a cytokine with important role in bone destruction limitation that occurs in psoriatic
arthritis. Material and methods: Our study was made on two patient groups. Group 1 consisting of
27 patients diagnosed with psoriatic arthritis based on CASPAR criteria, group 2 consisting of 21 pa-
tients diagnosed with rheumatoid arthritis, based on ARA criteria and the control group (healthy pa-
tients). Interleukin 13 was determined by the ELISA (Enzyme Linked Immuno Sorbant Assay). Res-
ults and discussion: In the case of the psoriatic arthritis group, the serum concentration of interleukin
13 was not much increased, but statistically significant as compared to the control group (p 1<0.01- S),
while in the case of the rheumatoid arthritis group, the serum concentration of interleukin 13 is higher
than in healthy patients (p2<0.002- ES, statistically intensive significant). Regarding the interleukin 13
concentration in the synovial liquid, we observed that the difference between the value of this cytokine
in psoriatic arthritis and rheumatoid arthritis patients is not very high, as compared to its blood value.
Conclusions: Our study proves the presence of significant differences regarding the interleukin 13 pro-
file in the serum and synovial liquid of the patients suffering from psoriatic arthritis, as compared to
healthy patients and patients suffering from rheumatoid arthritis. In this way, our study shows that the
pattern of local or systemic production of interleukin 13 can influence the clinical image of arthritis
with the apparition of psoriatic arthritis or rheumatoid arthritis, respectively. This shows the presence
of different pathogenetic mechanisms implicated in inflammatory articular diseases. Keywords: psori-
atic arthritis, rheumatoid arthritis, interleukin 13, antiinflammatory cytokines.
Importana determinrii interleukinei 13 n artrita psoriazic comparativ

cu artrita reumatoid
Ciacli Camelia1, Gligor Ramona1, Puchi Maria1, Gurban Camelia2, Crsnic Ioan1
1. Facultatea de Medicin, Farmacie i Medicin Dentar, Universitatea de Vest Vasile
Goldi, Arad; 2. UMF , Timioara
Introducere: n studiul nostru am evaluat concentraia sangvin i la nivelul lichidului sinovial
a interleukinei 13 (IL-13), citokin cu rol important n limitarea distruciei osoase care are loc n artrita
psoriazic. Material si metode: Studiul nostru a fost efectuat pe trei loturi de pacieni. Lotul 1 alctuit
din 27 pacieni diagnosticai cu artrit psoriazic pe baza criterilor CASPAR, lotul 2 alctuit din 21 pa-
cieni diagnosticai cu artrit reumatoid pe baza criteriilor ARA i lotul martor (subieci sntoi).
Interleukina 13 a fost determinat prin tehnica imunoenzimatic de tip sandwich ELISA (En-
zyme Linked Immuno Sorbant Assay). Rezultate i discuii: La lotul cu artrit psoriazic, concentraia
seric a interleukinei 13 nu este mult crescut, dar totui semnificativ statistic comparativ cu lotul
martor (p1<0.01- S, semnificativ statistic), n timp ce la lotul cu artrit reumatoid concentraia seric a
interleukinei 13 este mult mai mare dect la martorii sntoi (p2<0.002- ES, intens semnificativ statist-
ic). n ceea ce privete concentraia interleukinei 13 la nivelul lichidului sinovial am constatat c difer-
ena dintre valoarea acestei citokine la pacienii cu artrit psoriazic i artrit reumatoid nu este foarte
mare, spre deosebire de valoarea sangvin a acesteia. Concluzii: Studiul nostru demonstreaz existena
unor diferene semnificative n ceea ce privete profilul interleukinei 13 din serul i din lichidul sinovi-
al al pacienilor cu artrit psoriazic, comparativ cu martorii sntoi i cu pacienii cu artrit reumat-
oid. Astfel, studiul nostru ilustreaz c pattern-ul produciei locale sau sistemice a interleukinei 13
poate influena tabloul clinic al unei artrite cu apariia artritei psoriazice, respectiv a celei reumatoide,
ceea ce reflect existena unor mecanisme patogenetice diferite implicate n bolile articulare
inflamatorii. Cuvinte cheie: artrita psoriazic, artrita reumatoid, interleukina 13, citokine
antiinflamatorii.
P23. The importance of qualitative determination of antinuclear antibodies

in the diagnosis of collagen diseases
Vlceanu Ioana1, Iancu D.2
1. Dept.of Microbiology, Faculty of Medicine and Pharmacy Oradea; 2.Military Hospital
Oradea
Purpose:to establish the importance of using qualitative analysis of antinuclear antibodies
(ANA) in conjunction with other laboratory determinations and clinical examinations in the diagnosis
of collagen diseases. Material and method: study of a group of 60 patients diagnosed with diseases of
collagen: 24 with systemic lupus erythematosus (SLE), 18 with rheumatoid arthritis (RA), 8 with
sclerodermia, 7 with Sjogren syndrome (SS) and 3 with mixed connective tissue disease (MCTD);
there were performed qualitative determinations ANA for a parallel group of 60 subjects on which
there was no suspicion of collagen disease. There were conducted qualitative ANA determinations us-
ing ELISA method-type sandwich. Results: Qualitative analysis of ANA was positive in 24 (100%)
cases of SLE, 6 (33.3%) cases of RA, 4 (50%) cases of sclerodermia, 4 (57.1%) cases of SS, 2 (66.6%)
cases of MCTD. Determinations made on the paralel lot had positive results in 3 (5%) of subjects, one
in the age of 37 years and 2 patients of 67 and 69 years respectively. Conclusions: The qualitative de-
termination of ANA provides substantial aid in diagnosis of collagen diseases.It can appear positive
results in healthy people but in a small percentage (5%), with a higher incidence in the elderly.
Importana determinrii calitative a anticorpilor antinucleari n

diagnosticul bolilor de colagen
Vlceanu Ioana1, Iancu D.2
1. Catedra de Microbiologie, Facultatea de Medicin i Farmacie, Oradea; 2. Spitalul Clinic
Militar, Oradea
Scop: stabilirea importanei utilizrii analizei calitative a anticorpilor antinucleari (ANA), corob-
orat cu alte determinri paraclinice i examene clinice n diagnosticul bolilor de colagen. Material i
metod: s-a studiat un lot de 60 pacieni diagnosticai cu boli de colagen dintre care: 24 cu lupus
eritematos sistemic (LES), 18 cu poliartrit reumatoid (PR), 8 cu sclerodermie, 7 cu sindrom Sjogren
(SS) i 3 cu boala mixt de esut conjunctiv; s-au efectuat determinri calitative ANA i la un lot
paralel de 60 subieci la care nu exista suspiciune de boal de colagen. S-au efectuat determinri calita-
tive ANA prin metoda ELISA de tip sandwich. Rezultate: analiza calitativ a ANA a avut rezultate po-
zitive n 24 (100%) din cazurile de LES, 6 (33,3%) din cazurile de PR, 4 (50%) din cazurile de sclero-
dermie, 4 (57,1%) din cazurile de SS, 2 (66,6%) din cazurile de boal mixt de esut conjunctiv. Deter-
minrile efectuate pe lotul paralel au avut rezultate pozitive la 3(5%) din subieci, dintre care unul n
vrsta de 37 de ani i 2 pacieni de 67 i respectiv 69 ani. Concluzii: determinarea calitativ a ANA
ofer un ajutor substanial n stabilirea diagnosticului bolilor de colagen. S-au obinut rezultate pozitive
i la persoane snatoase dar ntr-un procent mic (5%), cu o inciden mai mare la persoanele vrstnice.
P24. The impact of HLA-B*5701 typing on HIV treatment using Abacavir

Dican Lucia1, Fischer G.F.2, Fa Ingrid2
1. Dept.of Medical Biochemistry University of Medicine and Pharmacy, Cluj-Napoca,
Romania; 2. Dept. for Blood Group Serology - Medical University, Vienna, Austria
Abacavir (ABC) is a nucleoside analogue and part of the standard HIV combination therapy.
ABC treatment results in a life threatening hypersensitivity reaction (HSR) in 5-8% of patients. A
strong association between the HSR and the presence of the HLA-B*5701 allele has been shown, the
B*5701 allele being part of a B57-DR7-DQ3 haplotype in most cases. We studied the impact of HLA-
B*5701 typing on the prescription rate and ABC-treatment cessations. HLA-B low resolution typing
was performed in 307 patients who have been treated with ABC in our unit between 09/1998 and
04/2008. 161 patients with treatment start before 08/2005 were typed retrospectively; the other 145
were typed prospectively. The HLA-B*57 patients were further typed by nucleotide sequencing of
HLA-B and low resolution typing of DRB1 and DQB1 alleles. Twenty - four patients were typed
HLA-B*57, 19 of them being B*5701. In 12 of the patients, additionally DRB1*07 and DQB1*03 al-
leles were found. The prescription rate before prospective HLA typing was 20 per year; afterwards it
went up to 88 per year. Five patients (3.4 %) of the prospective group discontinued ABC treatment
within 42 days after treatment start versus 21 patients (13%) in the retrospective group. In the prospect-
ive group no HSR was observed, while in the retrospective group eight cases have been observed. The
association of HSR and HLA-B*5701 was confirmed. Three patients having the HLA-B*5703 allele
did not show signs of HSR when exposed to the drug. In conclusion HLA-B*5701 typing prior to treat-
ment start decreased the rate of HSR. Consequently, the prescription rate was raised and the premature
ABC termination rate was reduced.
Impactul tipizrii HLA-B*5701 asupra tratamentului HIV cu Abacavir

Dican Lucia1, Fischer G.F.2, Fa Ingrid2
1. Catedra de Biochimie Medical UMF , Cluj-Napoca, Romnia; 2. Departamentul
Serologie Universitatea de Medicin, Viena, Austria
Abacavirul (ABC) este un analog nucleosidic care face parte din terapia combinat antiretrovir-
al pentru tratamentul adulilor infectai cu Virusul Imunodeficienei Umane (HIV). Tratamentul cu
ABC conduce la o reacie de hipersensibilitate (RHS) care amenin viaa a 5-8% pacieni. S-a
demonstrat o puternic asociere ntre RHS i prezena alelei HLA-B*5701, alela B*5701 fcnd parte
din haplotipul B57-DR7-DQ3 n majoritatea cazurilor. Noi am studiat impactul tipizrii HLA-B*5701
asupra nivelului de prescripie i a ntreruperii tratamentului cu ABC. Am realizat tipizarea HLA-B de
rezoluie joas la 307 pacieni care au fost tratai cu ABC. Un numr de 161 pacieni a cror tratament
a fost iniiat nainte de 08/2005 au fost tipizai retrospectiv; ceilali 146 pacieni au fost tipizai pros-
pectiv. Pacienii HLA-B*57 au fost tipizai prin secveniere nucleotidic HLA-B i prin tipizare de re-
zoluie joas pentru alelele DRB1 i DQB1. 19 pacieni au fost pozitivi pentru B*5701. La 12 pacieni
am detectat n plus alelele DRB1*07 i DQB1*03. Nivelul anual al prescrierii naintea tipizrii pros-
pective HLA era 20; apoi a crescut la 88. Cinci pacieni (3,4%) din grupul prospectiv au ntrerupt trata-
mentul cu ABC dup 42 zile de la debutul tratamentului fa de 21 pacieni (13%) aparinnd grupului
retrospectiv. n grupul prospectiv, nu s-a detectat RHS, n timp ce n grupul retrospectiv, am observat
opt cazuri de RHS. Asocierea ntre RHS i HLA-B*5701 a fost confirmat. Trei pacieni avnd alela
HLA-B*5703 nu au prezentat semnele RHS cnd au fost expui la medicament. In concluzie, tipizarea
HLA-B*5701 naintea nceperii tratamentului a redus rata RHS. n consecin, rata de prescripie a
crescut i rata de oprire prematur a tratamentului cu ABC a fost redus.
P25. Analysis of the correlation between autism and (GATA)n microsatellite

on the 5flanking region of the AVPR1A gene
Dobre Michaela1, Du-Cornescu Georgiana2, Simon-Grui Alexandra2, Constantin
Nicoleta2, Stoian Veronica2
1. Faculty of Medicine and Pharmacy, Dunrea de Jos University, Galai; 2. Faculty of
Biology, University of Bucharest
Objective: The neuron-anatomic distribution of the arginine-vasopresin receptor 1A and the
subsequent amount of arginine-vasopresin influences attachment and social behavior, thereby demand-
ing research on the correlation between AVPR1A gene and autism spectrum disorders (ASD). ASD
seriously impair intellectual development, bring about behavioral imbalances and often overlap with
mental retardation. Methods: The study was case-control type and involved three groups: 32 patients
diagnosed with mental retardation (MR), 19 patients suffering from ASD and 196 subjects with nor-
mally developed intellects as a control group. DNA was isolated from white blood cells, under in-
formed consent from authorized caretakers. The (GATA)n microsatellite, located on the 5UTR of the
AVPR1A gene, was analyzed by PCR PAGE technique, and the results were interrogated using pop-
ulation genetic specific programs. Results: 9 alleles associated to the microsatellite sequence previ-
ously amplified and designated A to I were identified. The allele frequencies calculated for each group
shown that allele A is missing on ASD patients (f(A)=0)), comparing to MR patients and control
(f(A)=0.031 and 0,013 respectively) Also, the frequency of allele D is higher on ASD and MR group
(0,368 and 0,328) comparative to the control group (0,281). Concerning the genotype frequencies, the
homozygous genotypes EE and HH are well represented in controls, but are absent in both patient
groups. Conclusions: The observed and expected data match in a satisfactory manner, and suggest that
all three groups are in a state of genetic balance.
Analiza corelaiei ntre autism i microsatelitul (GATA)n din regiunea

5flancatoare a genei AVPR1A
Dobre Michaela1, Du-Cornescu Georgiana2, Simon-Grui Alexandra2, Constantin
Nicoleta2, Stoian Veronica2
1. Facultatea de Medicin i Farmacie, Universitatea Dunrea de Jos, Galai; 2.
Facultatea de Biologie, Universitatea din Bucureti
Obiectiv: Distribuia receptorului 1A pentru arginin-vasopresin i cantitatea de arginin-
vasopresin influeneaz ataamentul i comportamentului social, justificnd oportunitatea studiului
corelaiei ntre gena AVPR1A i tulburrile din spectrul autismului (TSA) caracterizate prin dezech-
ilibru comportamental ce interfer adeseori cu retardul mental (RM). Metode: Studiul de tip caz-con-
trol a implicat trei grupuri: 32 de pacieni diagnosticai cu RM, 19 pacieni cu diagnostice de TSA i
196 de subieci normali din punct de vedere al dezvoltrii intelectuale, care au servit drept control.
ADN-ul a fost izolat din limfocite din snge, n urma semnrii consimmntului informat de ctre per-
soanele autorizate. Microsatelitul (GATA)n din regiunea 5UTR a genei AVPR1A a fost analizat prin
tehnica PCR-PAGE, rezultatele fiind interpretate prin programe specifice pentru genetica populaiilor.
Rezultate: Au fost identificate 9 alele asociate cu secvena microsatelitic amplificat crora le-au fost
atribuite denumiri de la A la I. n urma calculrii frecvenei alelice pentru fiecare din cele trei grupuri
s-a constatat c alela A lipsete la pacienii cu TSA (f(A)=0)) n comparaie cu grupul RM i grupul
martor (f(A)= 0.031 respectiv 0.013). De asemenea, frecvena alelei D este mai ridicat n TSA i RM
(0,368 i 0,328) comparativ cu grupul de control (0.281). n ceea ce privete frecvena genotipurilor,
genotipurile homozigote EE i HH sunt bine reprezentate n grupul de control dar lipsesc din ambele
grupe de pacieni. Concluzii: Exist o bun corelaie ntre valorile observate i cele ateptate ce sug-
ereaz c populaia luat n studiu (att pe grupuri ct i ca ntreg) este n echilibru genetic.
P26. Detection of large mutations by multiplex ligation-dependent probe

amplification (MLPA)
Iancu D., Talpe V., Neagu E., Iancu C.B., Constantinescu C., Grbea G.,
Constantinescu A., Giculescu M., Barbarii L.
National Institute of Legal Medicine "Mina Minovici", Bucureti
Multiplex Ligation-dependent Probe Amplification assay (MLPA) is a semiquantitative PCR-
based method which allows the analysis of over 40 DNA sequences in one single reaction tube. Since
its discovery in 2002 MLPA became the method of choice for the mutation screen of a large number of
genes. During the past four years we performed MLPA testing for patients affected by a large spectrum
of diseases like: Duchenne muscular dystrophy (348 patients), non-syndromic mental retardation (271
patients) and familial hypercholesterolemia (165 cases). All tests were part of our research projects.
We analyzed DNA samples extracted from whole blood obtained from affected patients after informed
consent. MLPA was performed with specific MLPA kits (MRC Holland). In Duchenne muscular dys-
trophy (DMD) cases we identified large mutations in 80% of samples. Most of these mutations were
deletions (85%) of one or more exons and about 15% were duplications. In 9% of the mental retarda-
tion cases a subtelomeric rearrangement was discovered by MLPA. On the contrary, in familial hyper-
cholesterolemia cases, only one large deletion was discovered. This finding was explained by the high
number of point mutations in LDLR gene that may escape MLPA analysis. Conclusions: MLPA is a
rapid, robust and cost-effective method, very useful in large mutations detection. It is particularly valu-
able for the mutation detection in large genes, where alternative PCR-based methods are costly and la-
borious. Point mutations are usually missed in MLPA analysis and require other methods (sequencing)
for confirmation.
Detectarea mutaiilor majore prin metoda MLPA (Multiplex Ligation-

Dependent Probe Amplification)
Iancu D., Talpe V., Neagu E., Iancu C.B., Constantinescu C., Grbea G.,
Constantinescu A., Giculescu M., Barbarii L.
Institutul Naional de Medicin Legal "Mina Minovici" Bucureti
MLPA este o metod semicantitativ bazat pe reacia PCR care permite analiza concomitent a
peste 40 fragmente ADN ntr-o singur reacie. De la descoperirea sa n 2002, MLPA a devenit metoda
de elecie pentru screening-ul mutaiilor ntr-un numr mare de gene. n ultimii patru ani s-au realizat
n laboratorul nostru teste MLPA pentru pacieni afectai de boli precum: distrofia muscular Duchenne
(348 pacieni), retard mental non-sindromic (271 cazuri), hipercolesterolemia familial (165 cazuri).
Probele analizate au constat n ADN extras din snge integral prelevat de la pacieni dup obinerea
consimmntului informat. Testul MLPA a fost realizat utiliznd kituri specifice fiecrei patologii
investigate (MRC Holland). Au fost identificate mutaii majore n 80% din cazurile de distrofie muscu-
lar Duchenne (DMD). Dintre acestea, 85% au fost deleii iar 15% duplicaii. Dintre cazurile de retard
mental 9% au prezentat rearanjri ale regiunilor subtelomerice care au putut fi indentificate prin
MLPA. n schimb, n cazul hipercolesterolemiei familiale, a fost identificat o singur mutaie major,
fapt explicat de frecvena mai mare a mutaiilor punctiforme ale genei LDLR, care nu sunt evideniate
de testul MLPA. Concluzii: MLPA este o metod rapid, robust i cu un bun raport cost/eficien,
foarte util pentru detectarea mutaiilor majore, mai ales la nivelul genelor de dimensiuni mari a cror
investigare prin metodele clasice bazate pe PCR ar fi extrem de costisitoare i laborioas. Dezavantajul
metodei const n scparea mutaiilor punctiforme a cror evideniere ar necesita aplicarea altor metode
(ex. secvenierea).
P27. Comparison of methods used for the detection of Aspirin resistance in

healthy volunteers
Kovcs EG, Bereczky Z, Haramura G, Tth E, Venczellk M, Muszbek L
Clinical Research Center, University of Debrecen, Medical and Health Science Center
Aim: The laboratory methods used for monitoring the effect of Aspirin (ASA) show poor correl-
ation. Due to methodological differences the frequency of ASA resistance among patients varies
between 5 and 30%. Our aim was to compare a number of laboratory methods used for the detection of
ASA resistance to a reference method established in our laboratory and identify the most suitable ones.
Materials and methods: Our reference method is based on the quantification of thromboxane B2
(TXB2), a stable metabolite of thromboxane A2, formed after activation of platelets in platelet rich
plasma by arachidonic acid (AA). PFA-100 closure time, Verify Now Aspirin Assay, platelet aggrega-
tion and secretion induced by collagen, epinephrine, ADP and AA were determined in 48 healthy vo-
lunteers on 100 mg/day ASA therapy. Samples were collected before, 1 and 7 days after the first dose.
Results: The effect of ASA was sensitively detected by the reference method and no resistant person
was found. The median of TXB2 concentration was 28,131 pg/mL (interquartile range: 19,931-37,666
pg/mL) before treatment and decreased significantly after 7 days on ASA (median: 399 pg/mL, in-
terquartile range: 321-507 pg/mL). The results obtained by the Verify Now Aspirin Assay and AA ag-
gregation/secretion were in good concordance with the results of the reference method. All other tests
presented variable results and poor correlation with the reference method. Conclusion: The results
suggest that the most appropriate routine laboratory methods for monitoring ASA therapy are the Veri-
fy Now Aspirin Assay and the platelet aggregation/secretion induced by AA.
Comparaia metodelor folosite pentru detectarea rezistenei la Aspirin pe

voluntari sntoi
Kovcs E.G., Bereczky Z., Haramura G., Tth E., Venczellk M., Muszbek L.
Universitatea din Debrecen, Centrul de tiine Medicale i de Sntate, Centrul de Cercetri
Clinice
Scopul lucrrii: Conform datelor din literatur, la terapia cu Aspirin aplicat profilactic
evenimentelor trombotice 5-30% dintre pacieni sunt rezisteni. Metodele de laborator folosite la
urmrirea efectului Aspirinei coreleaz slab, neexistnd metod de referin corespunztoare. Scopul
nostru a fost identificarea metodelor aplicabile cu eficacitate maxim prin comparaia metodelor
folosibile pentru urmrire i prin asemnarea acestora cu o metod de referin prelucrat de noi.
Materiale i metode: Metoda noastr de referin se bazeaz pe o determinare imunologic care dup
inducia trombocitelor cu acidul arahidonic (AA) detecteaz produsul stabil al tromboxanului A 2,
tromboxanul B2 (TXB2). Pe lng aplicarea acestei metode, am determinat timpul de nchidere PFA-
100, am efectuat Verify Now Aspirin Assay, examinrile agregrii i secreiei plachetare la agonitii
AA, colagen, ADP i epinefrin la 48 de voluntari sntoi, lund Aspirin 100 mg/zi, naintea primei
doze, dup 1 i 7 zile. Rezultate: Am constatat c metoda de referin indic n mod sensibil i sigur
inhibiia ciclooxigenazei (COX) de ctre Aspirin i conform datelor literaturii, tableta de Aspirin
filmat nu produce blocaj total COX ntr-o zi. Cu metoda de referin n-am gsit persoan rezistent,
mediana concentraiilor TXB2 fiind 399 pg/mL (regiunea intercvartil: 321-507 pg/mL) n ziua 7,
sczut semnificativ fa de valorile preterapeutice (median 28131 pg/mL, regiunea intercvartil: 19931-
37666 pg/mL). Verify Now Aspirin Assay, agregarea i secreia plachetar la AA au corelat totalmente
cu metoda de referin, celelalte metode producnd rezultate variate. Concluzii: Conform rezultatelor
obinute, dintre metodele studiate: Verify Now Aspirin Assay, examinrile agregaiei i secreiei
plachetare la AA sunt cele mai potrivite pentru urmrirea aspirinorezistenei.
P28. D-Dimers value in the diagnostic algorithm of venous

thromboembolism
Lighezan Rodica1, Olariu Rare2, Nistor Elena2, Nicola Doina2, Punescu Iulieta2, Bonte
Diana Camelia3, Lighezan Daniel Florin4
1. Histology Dept. of the Victor Babe Medicine and Pharmacy University, Timioara; 2.
Clinical Laboratory of the County Hospital, Timioara;3. Biochemistry Dept., Victor Babe
University of Medicine and Pharmacy, Timioara, Romania; 4. Cardiology Clinic of the
County Hospital, Timioara
Introduction: D-dimers are formed only through blood clotting. A variety of different qualitat-
ive and semi-quantifiable assays are available, with different diagnostic performances. Aim: To asess
the relation between the D-dimers value and the presence of deep vein thrombosis, or pulmonary em-
bolism using a rapid immunoturbidimetric method. Material and methods: The D-dimers concentra-
tion was assessed in 39 patients' venous whole blood using a rapid assay (Roche CARDIAC D-Dimer)
generating a positive/negative result (with D-dimer levels above and below a cut-off = 0.5 g/ml). The
following parameters were also measured in all patients on admission: CRP, fibrinogen, complete
blood count. Results: Between 39 cases, 16 patients (41%) showed normal D-dimer level (<0.5
g/ml), while 59% of patients had values between 0.6-3.3 g/ml. The final diagnosis was confirmed by
ultrasonography and pulmonary scintigraphy. No thrombosis was present in patients with D Dimers
lower than the cut-off, but not all the patients with higher D-Dimers levels had VTE or pulmonary em-
bolism. Discutions: An increase in d-Dimer levels may indicate the presence of an abnormally high
level of fibrin degradation products due to the activation of fibrinolysis, but d-Dimers also can be in-
creased by other factors such as infection, malignancies, inflammation, or pregnancy. Conclusion: D-
dimers assessment allowed us to rule out the diagnosis of deep vein thrombosis in a number of cases
but we also founded elevated DD concentrations in other clinical conditions.
Valoarea D-Dimerilor n algoritmul diagnostic al tromboembolismului

venos
Lighezan Rodica1, Olariu Rare2, Nistor Elena,2, Nicola Doina2, Punescu Iulieta2, Bonte
Diana Camelia3, Lighezan Daniel Florin4
1. Departamentul de Histologie al Universitii de Medicin i Farmacie Victor Babe,
Timioara; 2. Laboratorul Clinic al Spitalului Municipal, Timioara; 3. Departamentul de
Biochimie al Universitii de Medicin i Farmacie Victor Babe, Timioara; 4. Clinica de
Cardiologie a Spitalului Municipal, Timioara
Introducere: D-dimerii (DD) sunt fragmente desprinse n urma fibrinolizei secundare care are
loc sub influena plasminei. Exist numeroase teste calitative i semicantitative cu performane
diagnostice diferite. Scop: De a stabili rolul D-Dimerilor n diagnosticul pacienilor cu afeciuni ce
predispun la hipercoagulabilitate i trombembolie folosind o metod rapid imunoturbidimetric.
Material si metod: au fost investigai 39 pacieni folosind o metod rapid din snge integral (Roche
CARDIAC D-Dimer) cu valoare de cutt off de 0,5 g/ml. n plus au fost determinai pentru fiecare
pacient CRP, fibrinogen, i hemoleucograma. Rezultate: dintre pacieni 41%( n=16) au avut nivele ale
D-Dimerilor sub 0.5 g/ml, considerat valoare de cutt off, n vreme ce 59% din pacieni au avut valori
cuprinse ntre 0,6-3,3 g/ml. Diagnosticul de tromb-embolism a fost confirmat prin ecografie i
scintigrafie pulmonar. Nu au fost prezente tromboze la nici un pacient cu valori ale DD sub valoarea
de cutt-off, dar n schimb valori crescute ale DD au fost evideniate i la pacieni care nu prezentau
tromboze venoase sau embolie pulmonar. Discuii: Un nivel crescut al DD poate indica prezena
activrii fibrinolizei pe un tromb gata format, dar n acelai timp exist i alte condiii patologice, altele
dect tromboza, nsoite de nivele crescute ale DD ca de exemplu: infeciile, neoplaziile, inflamaia sau
sarcina. Concluzii: Determinarea DD ne-a permis excluderea trombozelor venoase la aproape jumtate
din pacienii studiai, dar am obsevat creterea DD i n alte stri patologice dect tromboza.
P29. The value of the NBT test in the study of the phagocytic reaction in
workers exposed to chrome derivatives
Lszl Annamria, Pacanu Ionela, Fazakas Zita, chiopu A.
University of Medicine And Pharmacy, Trgu Mure
Chrome is included in the cathegory of chemical substances with a modulator action on the
immune system and a cancerogen effect as well. A decrease of TH lymphocytes and an increase of TC
lymphocytes and of circulatory immune complexes were noticed in workers exposed to chrome during
their work. These modifications were correlated with the length of working time and the degree by
which the maximum concentration of chrome was exceeded. The values of the immunglobulins and of
the complement were normal. Others experienced an increase in the concentration of the
immunglobulin isothypes. There are few references in literature about the effect of the chrome on the
neutrophil granulocytes function. It is known that these cells are involved in the nonspecific defence of
the body. The research was carried on 30 persons, both sexes, aged 29-64 and the exposure to chrome
ranging between 2-37 years. Among them, 15 had been treated with Edetamin while 15 had not been
treated. In the group of untreated persons, in 40% of the cases an insignificant decrease of the NBT-
index (11.50%) was noticed while in 60% there was an increase of the index with (42.72%), the
average value being (14.43%). The presence of the chrome in adequate dose increases the percentage
of the NBT-positive test, underlying the stimulation of the neutrophil granulocytesphagocytic
capacity. The treatment with Edetamin decreases the NBT-positive test significantly.
Valoarea testului NBT n studiul reaciei fagocitare la muncitorii expui

derivailor de crom
Lszl Annamria, Pacanu Ionela, Fazakas Zita, chiopu A.
UMF Trgu Mure
Cromul este inclus n categoria substanelor chimice cu aciune modulatoare asupra sistemului
imun, avnd i efecte cancerigene. La muncitorii expui profesional la crom s-a constatat scderea
limfocitelor TH, creterea limfocitelor TC i a complexelor imune circulante, modificri care au fost
corelate cu vechimea stagiului de munc, respectiv cu nivelul depirii concentraiei maxime admise a
cromului. Valorile imunoglobulinelor i ale complementului au fost normale. Dimpotriv, la alii s-a
observat creterea concentraiei izotipurilor de imunoglobuline. n literatur se fac puine referiri
privind efectul cromului asupra funciei granulocitelor neutrofile. Ori, este tiut c aceste celule sunt
implicate n aprarea nespecific a organismului. Cercetrile au fost efectuate pe 30 de subieci de
ambele sexe, n vrst de 29-64 de ani, i cu expunere profesional la crom ntre 2-37 ani dintre care 15
netratai, iar 15 tratai cu Edetamin. n lotul celor netratai, la 40% din cazuri s-a constatat o scdere
nesemnificativ a indicelui NBT (11.50%), iar la 60% o cretere semnificativ a indicelui (42.72%)
fa de valoarea medie normal de 14.43%. Prezena cromului n doz adecvat crete procentajul
testului NBT-pozitiv, marcnd stimularea capacitii fagocitante a granulocitelor neutrofile.
Tratamentul cu Edetamin scade semnificativ testul NBT-pozitiv.
P30. The values of inflammatory parameters in patients with infected

wounds
Mo Ioana, Burt Olivia Ligia, Zdrnc Mihaela, Pelea Diana, Teaha Monica
1. Microbiology - Histology Dept., Faculty of Medicine and Pharmacy Oradea; 2.
Pharmacology Dept., Faculty of Medicine and Pharmacy, Oradea
Introduction: inflammatory blood samples having a low cost advantage, along with other clinic-
al and laboratory tests, are an important indicator in monitoring infection. Objectives: The aim of the
study was to track the changes of inflammatory parameters (number of leucocytes, the sedimentation
rate of red blood, C reactive protein) according to the clinical appearance, the type of wound and skin
infection type caused by one or many bacterial germs. Material: The study included 164 patients with
infected wounds (surgical wounds, trauma wounds, burns and skin ulcers). Patients were initially eval-
uated for tracking clinical signs and symptoms of infection. Also, each patient was collected from
wound secretions to determine the type of infection and blood samples for determination of inflammat-
ory parameters. Results: Depending on the wound, the results were the following: C reactive protein
was increased in 81.7% of cases with a high prevalence in burns and surgical wounds; increased num-
ber of leucocytes was present in 25.6% of cases, sedimentation rate of red blood cells registered high
values in all types of wounds, the highest being in burns and surgical wounds. Regarding the type of
infection, C reactive protein only presented significant variations. Conclusions: The usual inflammat-
ory parameters present variations depending on the type of wound and type of infection, the most faith-
ful indicator being C reactive protein.
Valorile parametrilor inflamatori la pacienii cu plgi infectate

Mo Ioana, Burt Olivia Ligia, Zdrnc Mihaela, Pelea Diana, Teaha Monica
1. Catedra Microbiologie Histologie, Facultatea de Medicin i Farmacie, Oradea; 2.
Catedra de Farmacologi, Facultatea de Medicin i Farmacie, Oradea
Introducere: Probele sanguine inflamatorii avnd avantajul unui cost redus, alturi de alte teste
clinice i paraclinice, reprezint un indicator important n monitorizarea infeciei. Obiective: Scopul
studiului a fost urmrirea variaiei parametrilor inflamatori (numr de leucocite, vitez de sedimentare
a hematiilor, protein C reactiv) n funcie de aspectul clinic, tipul de plag cutanat i tipul de infecie
(mono sau pluribacterian). Material: Studiul a cuprins 164 de pacieni cu plgi infectate (plgi chirur-
gicale, plgi traumatice, arsuri i ulcere cutanate). Pacienii au fost iniial evaluai clinic pentru urmri-
rea semnelor i simptomelor de infecie. De asemenea, fiecrui pacient i s-au recoltat secreii din plag
pentru stabilirea tipului de infecie i probe de snge pentru determinarea parametrilor inflamatori.
Rezultate: n funcie de tipul de plag s-au constatat urmtoarele: proteina C reactiv a prezentat valori
crescute n 81,7% din cazuri, cu o prevalen ridicat n arsuri i plgi chirurgicale; leucocitoza a fost
prezent n 25,6% din cazuri; viteza de sedimentare a hematiilor a nregistrat valori crescute n toate
tipurile de plgi, cele mai ridicate fiind n arsuri i plgi chirurgicale. n ceea ce privete tipul de in-
fecie doar proteina C reactiv a prezentat variaii semnificative. Concluzii: Parametrii inflamatori uzu-
ali prezint variaii n funcie de tipul de plag i tipul infeciei, cel mai fidel indicator fiind proteina C
reactiv.
P31. Immun-inflamatory correlations in the coronary artery disease

Sfrijan Felicia1, Golieanu Madalina2, Mihala Adrian1, Gotia Smaranda3, Gotia Laura3,
Puschita Maria4, Ciacli Camelia4, Gurban Camelia1
1. Biochemistry Dept., Victor Babe University of Medicine and Pharmacy, Timioara,
Romania; 2. Individual Medical Center, Galai, Romania; 3. Physiology Dept., Victor
Babe University of Medicine and Pharmacy Timioara, Romania; 4. Cardiology Dept.,
Faculty of Medicine, Pharmacy and Dental Medicine, Vasile Goldi Western University,
Arad, Romania
Objective: This study was conducted to correlate the serum level of proinflammatory cytokines
IL-1, IL-6, TNF and IL-12 in patients with coronary atherosclerosis, to estimate the proportion of
immune-inflammatory answer and Th1 prevalent feature in coronary artery disease and to test the hy-
pothesis that the serum level of cytokines is a common predictor of plaque destabilization. Material
and methods: Samples were obtained from patients with acute myocardial infarction-AMI (70), stable
angina-SA (50) and from healthy subjects (40). ELISA assay was used for quantification of serum
levels of cytokines. Results: Patients with AMI had significantly grown serum levels of IL-1
(p<0.01), IL-6 (p<0.05), TNF (p<0.001) and IL-12 (p<0.05) compared with the healthy group. There
is an intense positive correlation in AMI group between this cytokines. The SA group differentiates
from the healthy group only through grown serum levels of TNF (p<0.001) and IL-12 (p<0.05). Con-
clusions: Grown levels of proinflammatory cytokines IL-12 and TNF confirm the fact that the inflam-
matory reaction appears precocious in atherosclerotic lesion and influences the progress and the stabil-
ity of plaque. Cytokines IL-1, IL-6, TNF and IL-12 could be indicators for the prediction of the car-
diac risk. Key words: proinflammatory cytokines, IL-1, IL-6, TNF, IL-12, atherosclerosis, cardiac
risk.
Corelaii imun-inflamatorii n boala coronarian

1. Catedra de Biochimie,UMF Victor Babe, Timioara, Romnia; 2. Cabinet Medical
Individual, Galai, Romnia; 3. Catedra de Fiziologie,UMF Victor Babe, Timioara,
Romnia; 4. Catedra de Cardiologie, Facultatea de Medicin, Farmacie i Medicin
Dentar, Universitatea de Vest Vasile Goldi, Arad , Romnia
Scop: Acest studiu a avut ca scop analiza corelaiilor dintre concentraiile serice ale citokinelor
proinflamatoare IL-1, IL-6, TNF i IL-12 la pacienii cu ateroscleroz coronarian, aprecierea
rspunsului imun-inflamator n boala coronarian i verificarea ipotezei potrivit creia citokinele pot fi
utilizate ca indicatori ai instabilitii plcii aterosclerotice. Material i metode: Probele au fost
obinute de la pacieni cu infarct miocardic acut-IMA (70), angin stabil-AS (50) i de la martori (40).
Pentru determinarea concentraiilor serice ale citokinelor s-a folosit metoda imunoenzimatic (ELISA).
Rezultate: Comparativ cu lotul martor, pacienii cu IMA au prezentat concentraii serice semnificativ
crescute ale IL-1 (p<0.01), IL-6 (p<0.05), TNF (p<0.001) si IL-12 (p<0.05). Exist corelaii intens
pozitive n grupul IMA ntre aceste cytokine. Diferene semnificative statistic ntre grupul AS i mar-
tori sunt numai n ce privete TNF (p<0.001) i IL-12 (p<0.05). Concluzii: Concentraiile serice cres-
cute ale citokinelor IL-12 i TNF confirm faptul c inflamaia apare precoce n leziunile ateroscler-
otice i influeneaz progresia i stabilitatea plcii. Citokinele IL-1, IL-6, TNF i IL-12 pot fi utiliz-
ate ca indicatori ai riscului cardiovascular. Cuvinte cheie: citokine proinflamatorii, IL-1, IL-6, TNF,
IL-12, ateroscleroz, risc cardiovascular.
P32. Interferon - Gamma Inducing factor biomarker of atherosclerotic

plaque instability
Romania; 2. Individual Medical Center, Galai, Romania; 3. Physiology Dept., Victor
Babe University of Medicine and Pharmacy Timioara, Romania; 4. Cardiology Dept.,
Faculty of Medicine, Pharmacy and Dental Medicine, Vasile Goldi Western University,
Arad, Romania
Objective: This study was conducted to analyze the circulating level of Interferon-gamma indu-
cing factor in patients with acute myocardial infarction (AMI), unstable angina (UA), stable angina
(SA), and to estimate the proportion of immune-inflammatory answer and Th1 prevalent feature in
coronary artery disease. Material and methods: Samples were obtained from patients with acute
myocardial infarction (70), unstable angina (40), stable angina (50) and from control subjects (40).
ELISA assay was used for quantification of serum levels of Interferon-gamma inducing factor. Res-
ults: Compared with the control group (0.890.15 pg/ml), the levels of Interferon-gamma inducing
factor were significantly higher in the all groups of patients (AMI - 5.871.20 pg/ml, p<0.05; IA -
3.820.70 pg/ml, p<0.05; SA - 2.540.44 pg/ml, p<0.05). There were no statistically significant differ-
ences in the concentration of Interferon-gamma inducing factor among the angina groups (p>0.05).
Conclusions: The concentrations of Interferon-gamma inducing factor were significantly higher in the
coronary artery disease groups. These results were related to the Th1 inflammatory responses in athero-
sclerosis and suggest that Interferon-gamma inducing factor is involved both, in initial stages of devel-
opment of coronary atherosclerosis and in circumstance of plaque destabilization. Key words: Interfer-
on-gamma inducing factor, atherosclerosis, coronary artery disease, and inflammation.
Factorul inductor de interferon gamma biomarker al instabilitii plcii

aterosclerotice
1. Catedra de Biochimie,UMF Victor Babe, Timioara, Romnia; 2. Cabinet Medical
Individual, Galai, Romnia; 3. Catedra de Fiziologie,UMF Victor Babe, Timioara,
Romnia; 4. Catedra de Cardiologie, Facultatea de Medicin, Farmacie i Medicin
Dentar, Universitatea de Vest Vasile Goldi, Arad , Romnia
Scop: Acest studiu a avut ca scop evaluarea concentraiilor serice ale Factorului inductor de in-
terferon gamma la pacienii cu infarct miocardic acut (IMA), angin instabil (AIS), angin stabil
(AS), estimarea rspunsului inflamator i prevalena Th1 n boala coronarian. Material i metode:
Probele au fost obinute de la pacieni cu IMA (70), AIS (40), AS (50) i de la martori (40). Pentru de-
terminarea concentraiilor serice ale Factorului inductor de interferon gamma s-a folosit metoda imun-
oenzimatic (ELISA). Rezultate: Comparativ cu lotul martor (0.890.15 pg/ml), concentraiile serice
ale Factorului inductor de interferon gamma au fost semnificativ mai mari la toate loturile de pacieni
(IMA - 5.871.20 pg/ml, p<0.05; AIS - 3.820.70 pg/ml, p<0.05; AS - 2.540.44 pg/ml, p<0.05). Nu
exist diferene semnificative statistic ntre concentraiile serice ale Factorului inductor de interferon
gamma ale celor dou loturi de angine (p>0.05). Concluzii: Concentraiile serice ale Factorului induct-
or de interferon gamma au fost semnificativ crescute la toi pacienii cu boal coronarian. Acest
rezultat este sugestiv pentru prevalena Th1 din inflamaia aterosclerotic i sugereaz implicarea
Factorului inductor de interferon gamma n toate stadiile evolutive ale aterosclerozei. Cuvinte cheie:
factorul inductor de interferon gamma, ateroscleroz, boala coronarian, inflamaie.
P33. Immunohistochemical markers in thyroid lesions and their differential

diagnoses: utility of CK19, HBME1 combined with galectin 3
immunostaining
Cornianu Marioara, Golu Ioana, Amzar Daniela, Lazureanu Codruta, Costi Simona,
Faur Alexandra, Zosin Ioana
Victor Babe University of Medicine and Pharmacy Timioara
Background: The histopathological distinction between some types of different thyroid tumors
can be difficult even for experienced pathologists. The aim of our work was to study
immunohistochemical expression of cytokeratin19 (CK19), galectin-3 (Gal-3) and HBME-1 in thyroid
lesions and to assess their usefulness as markers in the differential diagnoses of thyroid nodules.
Material and methods: Formalin-fixed paraffin-embedded tissues from 42 patients with thyroid
tumors (18 PTC, 5 FTC, 4 TUMP, 12 FA, 2 papillary hyperplasia), were processed using DAKO En
Vision method. After the examination of multiple microscopic fields, the results were expressed semi-
quantitatively, according to the estimated percentage of positive tumor cells.
Results: The immunoreaction for CK19 and HBME showed mainly a cytoplasmatic staining
pattern. Positive and diffuse immunoreaction was noticed in most of the PTC followed by FTC. PTC
metastases also presented an intense positive immunoreaction. 7/12 FA were negative for HBME-1
(75%), and the positive ones presented a weak and focal immunoreaction. In the present study 94% of
PTC showed positive immunoreaction with diffuse and moderate pattern (2+), in the cytoplasm and,
sometimes, nucleus for galectin 3. Diffuse and weak to moderate cytoplasmatic Gal-3
immunoexpression was noticed in 60% of FTC (3 out of 5 cases). Gal-3 was not expressed in 10/12
FA. The expression rates of the three markers between benign lesions and malignant lesions were
statistically significant.
Conclusions: These results indicate that some individual antibodies or a panel of antibodies
combined with histopathological analysis can be useful in separating follicular adenoma (FA) from
follicular variant of papillary thyroid carcinoma (PTC).
Markerii imunohistochimici n leziunile tiroidiene i diagnosticul lor

diferenial: utilitatea imunoreaciei CK19, HBME1combinat cu galectina 3
Cornianu Marioara, Golu Ioana, Amzar Daniela, Lazureanu Codruta, Costi Simona,
Faur Alexandra, Zosin Ioana
UMF Victor Babe Timioara
Scopul: Diferentierea histopatologic a tumorilor tiroidiene poate fi dificil i pentru
anatomopatologi cu experien. n acest studiu am evaluat expresia markerilor imunohistochimici
citokeratina 19 (CK19), galectina 3, HBME1 n leziunile tiroidiene i utilitatea acestora n diagnosticul
diferenial al nodulilor tiroidieni.
Material i metode: Seciuni seriate incluse n parafin de la 42 de cazuri de tumori tiroidiene
(18 CTP, 3 CTF, 4 TPMI, 12 AF, 2 hiperplazii papilare) au fost analizate prin metoda Dako EnVisson.
Dup examinarea microscopic, rezultatele au fost exprimate semicantitativ, potrivit procentului de
celule tumorale pozitivate.
Rezultate: Imunoreacia CK19 i HBME1 a evideniat n principal un pattern de colorare
citoplasmatic. Imunoreacia pozitiv i difuz (moderat/intens) s-a observat n majoritatea CTP,
urmat de CTF. De asemenea, imunoreacie pozitiv intens au prezentat i metastazele din CTP. 7/12
AF au fost negative pentru HBME-1 (75%), iar cele pozitive au avut o imunoreacie slab i focal.
n studiul nostru, 94% din CTP au prezentat imunoreacie pozitiv difuz i moderat (2+),
citoplasmatic i ocazional nuclear pentru galectina 3. n CTF, imunoexpresia Gal-3 a fost de 60% (3
din 5 cazuri). Gal-3 nu s-a exprimat n majoritatea AF, doar 2 din cele 12 cazuri au prezentat o
imunoreacie focal (1+).
Intensitatea imunoreaciei n nodulii benigni versus maligni a prezentat diferene semnificative
statistic, pentru toi cei trei markeri studiai.
Concluzie: Utilizarea acestui panel de markeri i coroborarea rezultatelor obinute cu
diagnosticul morfopatologic a indicat o bun valoare diagnostic n difereniere adenoamelor foliculare
de CTPVF.
P34. GSTP1 hypermethylation, a biomarker in the molecular diagnosis of

prostate cancer
Dumache Raluca1, Puiu Maria1, Bumbcila Bogdan1, Anton Gabriela2, Cucu Natalia3
1. University of Medicine and Pharmacy ''Victor Babe'', Timioara, Romnia; 2. National
Institute of Virology, Bucharest, Romania; 3. Faculty of Biology, University of Bucharest,
Romania
Introduction: Prostate cancer is the most frequently diagnosed cancer in the male population
and the second leading cause of cancer mortality among men. GSTP1 hypermethylation occurs during
carcinogenesis and is considered to be a major event of prostate carcinogenesis. Materials and meth-
ods: For our study we used tissue and blood samples from 27 patients with the histologically diagnosis
of PCa, Gleason score 4 to 7, and 24 patients with the diagnosis of BPH. Patients age enrolled in our
study was 50 to 80 years, and the total PSA values were in a range of 4 to 42 ng/ml. We used the
methylation-specific PCR (MSP) methods to detect the GSTP1 hypermethylation in prostate cancer
samples. Results: GSTP1 promoter hypermethylation was detected in 25 from 27 prostate cancer
samples (92.6%), but it was not detected in samples from patients with benign prostatic hyperplasia.
Conclusion: GSTP1 hypermethylation distinguishes between prostate cancer and benign prostatic hy-
perplasia and it can be used as a biomarker for prostate cancer screening and early diagnosis.
Keywords: prostate cancer (PCa), benign prostatic hyperplasia (BPH), PSA (prostate specific antigen),
glutathione-S-transferase P1 (GSTP1), methylation-specific PCR (MSP).
Hipermetilarea GSTP1, un biomarker n diagnosticul molecular al

cancerului de prostat
Dumache Raluca1, Puiu Maria1, Bumbcila Bogdan1, Anton Gabriela2, Cucu Natalia3
1.UMF ,,Victor Babe, Timioara, Romnia; 2. Institutul Naional de Virusologie,
Bucureti, Romnia; 3. Facultatea de Biologie, Universitatea din Bucureti, Romnia;
Introducere: Cancerul de prostat este cel mai frecvent tip de cancer diagnosticat n rndul
brbailor i reprezint a doua cauz a mortalitii n rndul acestora. Hipermetilarea GSTP1 apare n
cursul carcinogenezei i reprezint o etap important n cursul carcinogenezei prostatei. Material i
metode: Pentru acest studiu , am folosit probe de snge i esut de la un numr de 27 pacieni cu
diagnosticul histopatologic de adenocarcinom de prostat, scor Gleason 4-6, i un numr de 24 pacieni
cu diagnosticul de hiperplazie benign de prostat. Vrsta pacieniilor este ntre 50-80 ani, pacienii
avnd valori ale PSA total cuprinse ntre 4-42 ng/ml. Pentru determinarea hipermetilrii GSTP1 n
produsele biologice am folosit metoda metilrii specifice PCR. Rezultate: Hipermetilarea GSTP1 a
fost detectat n 25 din cele 27 de probe de la pacienii cu CaP (92.6%), dar nu a fost detectat n nici
una dintre probele pacieniilor cu HBP. Concluzie: Hipermetilarea GSTP1 poate fi folosit ca
biomarker n screeningul CaP i diagnosticarea n stadiu incipient al acestei boli. Cuvinte cheie: cancer
de prostat (CaP), hiperplazie benign de prostat (HBP), glutation-S-transferaza P1 (GSTP1), metilare
specific PCR (MSP); antigen specific prostatic (PSA).
P35. Detection of CD24 gene in prostate cancer tissue samples

Dumache Raluca1, Puiu Maria1, Kaycsa Adriana1, erban C.1, Anton Gabriela2
1. Victor Babe University of Medicine and Pharmacy Timioara; 2. National Institute of
Virusology Bucharest
Introduction: Knowledge about molecular alterations in prostate cancer have been increasing
over the past years, due to the new discoveries in molecular genetics.
In our study we want to detect by qRT-PCR method, the expression of CD24 gene in prostate
cancer tissue and compare it with the benign prostatic hyperplasic tissue.
Material and methods: We collected using needle biopsy tissue samples from 15 patients dia-
gnosed with prostate cancer, with Gleason score 4-7, and total PSA levels between 12-38 ng /ml, and
18 patients diagnosed with benign prostatic hyperplasia, total PSA levels between 4-10 ng/ml.
Results: Over expression of CD24 gene was observed in prostate cancer tissue samples. CD24
gene could be considered a useful biomarker in the detection of prostate cancer from prostate tissue
samples.
Keywords: qRT-PCR (quantitative real-time PCR), PCa (prostate cancer), BPH (benign prostatic
hyperplasia), CD24 gene, PSA (prostate specific antigen)
Determinarea expresiei genei CD24 n esutul prostatic malign

Dumache Raluca1, Puiu Maria1, Kaycsa Adriana1, erban C.1, Anton Gabriela2
1. UMF Victor Babe Timioara; 2. Institutul Naional de Virusologie Bucureti
Introducere: n ultimii ani noile descoperiri n domeniul geneticii moleculare au adus informaii
despre alterrile moleculare care apar n cancerul de prostat.
n studiul nostru dorim s determinm folosind metoda RT-PCR cantitativ, expresia genei
CD24 n esutul prostatic malign, comparativ cu cea din esutul prostatic benign.
Material i metode: Prin puncie biopsie prostatic am obinut esut prostatic de la 15 pacieni
diagnosticai cu cancer de prostat, scor Gleason 4-7, PSA total ntre 12-38 ng/ml, i 18 pacieni dia-
gnosticai cu hipertrofie benign de prostat, i nivelul PSA total ntre 4-10 ng/ml.
Rezultate: Gena CD24 a fost supraexprimat doar n cazul pacieniilor cu cancer de prostat.
Gena CD24 ar putea fi considerat un biomarker util n diagnosticarea cancerului de prostat din e-
sutul prostatic.
Cuvinte cheie: Cancer de prostat, gena CD24, PSA (antigen specific prostatic), HBP (hipertro-
fie benign de prostat)
P36. Malignant transformation of the epithelial component in Warthins

tumor
Faur Alexandra1, Lazr Elena1, Cornianu Marioara1, Dema Alis1, Lzureanu Codrua1,
Costi Simona1, Gurban Camelia Vidia2
1. Dept. of Pathology, Victor Babe University of Medicine and Pharmacy Timioara; 2.
Dept. of Biochemistry, Victor Babe University of Medicine and Pharmacy Timioara
In 1929, pathologist Aldred Warthin described for the first time the tumor papillary cystadenoma
lymphomatosum - since than it was knowed especially as Warthin tumor. Warthin tumor is a benign
salivary neoplasm occurring mainly in the parotid gland, with an epithelial component and a lymphoid
stroma. However, rarely, either the epithelial or the lymphoid component of Warthin tumor can under-
go malignant transformation. Malignant transformation of the lymphoid component is relatively com-
mon but the epithelial malignancy is very rare.
The aim: We present a rare case with in situ carcinoma and squamous metaplasia arising in a
Warthin tumor of a parotid gland in a 79-year-old man and the differential diagnosis to be considered
for this case.
Material and methods: Formalin-fixed paraffin-embedded tissue samples were cut at 4m and
stained using hematoxilin and eosin (HE). For the immunohistochemical evaluation we have used
monoclonal antibodies against cytokeratin (CK) (MNF 116, Dako) and epithelial membrane antigen
(EMA)(E29, Dako) with EnVision (K5007, Dako) visualisation system.
Results: On HE stain, Warthin tumor was composed of papillary cystic structures lined by a
bilayered oncocytic epithelium and lymphoid stroma and areas with squamous metaplasia and in situ
carcinoma. Immunohistochemically, the benign squamous metaplastic areas and the in situ carcinoma
were positive at EMA and CK.
Conclusion: The epithelial malignancy was labeled with CK and EMA. The main differential
diagnosis in this case must be made with an invasive squamous carcinoma and metastasis from such
primary carcinoma of another site.
Malignizarea componentei epiteliale n tumora Warthin

Faur Alexandra1, Lazr Elena1, Cornianu Marioara1, Dema Alis1, Lzureanu Codrua1,
Costi Simona1, Gurban Camelia Vidia2
1. Disciplina de Morfopatologie, UMF Victor Babe Timioara; 2. Disciplina de
Biochimie, UMF Victor Babe Timioara
Patologul Aldred Warthin descrie pentru prima dat n 1929, o formaiune tumoral, pe care o
denumete papillary cystadenoma lymphomatosum - de atunci, aceast tumor este cunoscut mai ales
ca tumora Warthin. Tumora Warthin este o neoplazie benign a glandelor salivare care intereseaz n
principal glanda parotid, fiind alctuit dintr-o component epitelial i o strom limfoid. Cazurile cu
malignizare a componentei stromale limfoide sunt ntlnite mai frecvent, pe cnd tumorile Warthin
malignizate pe linie epitelial sunt neobinuite.
Scop: Prezentm cazul unui pacient de 79 de ani cu tumor Warthin cu metaplazie scuamoas,
pe care s-a dezvoltat un carcinom in situ, discutnd i diagnosticul diferenial care se impune n
asemenea situaii.
Material i metode: Fragmentele tisulare au fost fixate n formol, incluse in parafin, secionate
la o grosime de 4m i colorate cu hematoxilin i eozin (HE). Pentru evaluarea imunohistochimic
am utilizat anticorpii monoclonali: citokeratin (CK) (MNF 116, Dako) i antigenul membranar
epitelial (EMA) (E29, Dako), folosind sistemul de vizualizare EnVision (K5007, Dako).
Rezultate: pe coloraia HE tumora Warthin este alctuit din structuri chistice papilare
mrginite de un strat epitelial dublu de oncocite i o strom limfoid. Asociat, sunt prezente zone de
carcinom in situ i metaplazie scuamoas. Imunohistochimic, ariile benigne cu metaplazie scuamoas
i cele de carcinom in situ au fost pozitive la CK i EMA.
Concluzii: diagnosticul de neoplazie de origine epitelial a fost stabilit imunohistochimic prin
pozitivarea la CK i EMA. Diagnosticul diferenial se impune cu un carcinom scuamocelular invaziv
sau metastazele parotidiene ale unui asemenea carcinom.
P37. Left ventricular hypertrophy induced by aortic constriction in rats

electrical and mechanical findings
Scridon Alina, Dobreanu Dan, Perian Marcel, Serban Rzvan C.
Department of Physiology, University of Medicine and Pharmacy and Emergency Institute of
Cardiovascular Diseases and Transplant, Adults Cardiology Clinic I, Targu Mures, Romania
Background: As response to a large variety of stimuli the myocardium adapts through the hyper-
trophy of individual muscle cells. The mechanisms involved in pathological left ventricular hyper-
trophy (LVH) are far from clear.
Aim of the study: The purpose of this study was to evaluate the electrical and mechanical
changes associated with pathological LVH.
Material and methods: Thirty Wistar rats were randomly assigned into two groups: control group
(CONT) and the group with aortic constriction (PATH). For PATH, the aorta was isolated above the
origin of renal arteries, a needle of 0.6gauge was placed longitudinally and the aorta was reduced to the
dimensions of the needle. Cardiac weight, LV weight/body weight ratio and histological measurement
of myocites were used to confirm the presence of LVH. Action potential duration to 90, 75, 50 and
25% of complete repolarization (APD) and the velocity of depolarization (p/t) were measured as
electrical parameters, and peak tension (PT), time to peak tension (TPT) and time to half relaxation
(T1/2R) as mechanical parameters. To investigate the possible role of excitation-contraction coupling
alteration in pathological LVH we compared simultaneously recorded mechanical and electrical activ-
ity of normal and hypertrophied muscles.
Results: For PATH the criteria for LVH were fulfilled. The APD recorded from PATH rats was
substantially longer than that recorded from CONT. The AP prolongation was based especially on the
prolongation of repolarization (APD90 increased by 81.6%, p<0.0001). PATH also showed a signific-
ant increase in PT, TPT and T1/2R (p<0,0001).
PARAMETER CONT PATH

APD90 (msec) 75.441.03 136.980.44
APD75 (msec) 45.440.67 78.110.45
APD50 (msec) 21.120.61 26.060.59
APD25 (msec) 13.020.83 14.410.38
p/T (V/sec) 15.490.62 13.610.23
PT (N) 485.62.28 880.061.66
TPT (msec) 87.962.30 105.020.21
T1/2R (msec) 126.022.76 220.061.43
Electrical and mechanical parameters measurements
There was as significant correlation between APD75, APD50 and all three parameters of con-
traction for CONT and only with TPT and T1/2R for PATH.
Conclusions: The APD prolongation based on the prolongation of repolarization in PATH could
explain cardiac arrhythmias noticed in patients with pathological LVH. The fact that PATH showed a
significant correlation between only two parameters of contraction and APD suggests that this state
may develop alterations in electro-mechanical coupling.
Hipertrofia ventricular stng indus prin constricie de aort modificri

ale fenomenelor electrice i mecanice
Scridon Alina, Dobreanu Dan, Perian Marcel, erban Rzvan C.
Disciplina de Fiziologie, Universitatea de Medicin i Farmacie i Institutul de Urgen de
Boli Cardiovasculare i Transplant, Clinica Cardiologie I Aduli, Trgu Mure, Romnia
Introducere: Ca rspuns la o larg varietate de stimuli miocardul se adapteaz necesitilor cres-
cute prin hipertrofia miocitelor. Mecansimele implicate n hipertrofia ventricular stng (HVS) pato-
logic sunt departe de a fi complet elucidate.
Scopul studiului: A fost acela de a evalua modificrile fenomenelor electrice i mecanice aso-
ciate HVS patologice.
Material i metod: Treizeci de obolani Wistar au fost distribuii n dou grupuri: grupul control
(CONT) i grupul cu constricie aortic (PATH). n cazul PATH, aorta a fost izolat deasupra emer-
genei arterelor renale, un ac de 0,6gauge a fost plasat longitudinal, iar aorta a fost redus la dimensi-
unile acului. Masa cardiac, raportul mas VS/mas corporal i o serie de msurtori histologice ale
miocitelor au fost utilizate pentru a confirma dezvoltarea HVS. Ca parametrii electrici au fot msurai
durata potenialului de aciune pn la atingerea a 90, 75, 50 i 25% din repolarizarea complet (APD)
precum i viteza depolarizrii (p/t), iar ca parametrii mecanici amplitudinea maxim a contraciei
(PT), timpul pn la atingerea amplitudinii maxime a contraciei (TPT) i timpul pn la jumtatea re-
laxrii (T1/2R). Pentru a investiga posibilul rol al alterrii cuplului excitaie-contracie, am comparat
activitatea mecanic i electric, nregistrate simultan la muchii papilari normali i hipertrofiai.
Rezultate: Pentru PATH au fost ndeplinite criteriile de HVS. APD nregistrat pentru PATH a
fost semnificativ mai mare dect cea nregistrat pentru CONT. Alungirea AP s-a bazat mai ales pe
alungirea repolarizrii (APD90 a crescut cu 81,6%, p<0,0001). Pentru PATH am obinut deasemenea
alungirea semnificativ a PT, TPT i T1/2R (p<0,0001).
PARAMETRU CONT PATH

APD90 (msec) 75,441,03 136,980,44
APD75 (msec) 45,440,67 78,110,45
APD50 (msec) 21,120,61 26,060,59
APD25 (msec) 13,020,83 14,410,38
p/T (V/sec) 15,490,62 13,610,23
PT (N) 485,62,28 880,061,66
TPT (msec) 87,962,30 105,020,21
T1/2R (msec) 126,022,76 220,061,43
Parametrii electrici i mecanici
Pentru CONT am obinut o corelaie semnificativ ntre APD75, APD50 i toi cei trei paramet-
rii ai contraciei, n timp ce PATH a prezentat o corelaie semnificativ a APD doar cu TPT i T1/2R.
Concluzii: Alungirea APD bazat pe alungirea repolarizrii la PATH ar putea explica apariia ar-
itmiilor cardiace observate la pacienii cu HVS patologic. Faptul c PATH a prezentat o corelaie
semnificativ ntre doar doi parametrii ai contraciei i APD sugereaz faptul c aceast stare s-ar putea
nsoi de alterri ale cuplului electro-contractil.
P38. Biobanking
Saizu Ana Magdalena1, Gheoca Roxana2
1. Timioara Districtual Emergency Hospital Clinics; 2. Timioara County Emergency
Hospital Clinics
Biobanks are organised collections of biologic samples and associated data, which are gathered,
stored and processed, with a scientific purpose.
The term biobank is relatively new, being mentioned for the first time in PubMed in 1996, but
its frequency increased after 2000.
The number of biobanks is up to few hundred millions and is rapidly and continuously growing.
At first, each biobank was a support for a research program which had a certain disease as a
theme and required the study of only one type of tissue. To reduce the costs, today, biobanks are col-
lecting many types of biologic material and data.
The biobank must secure the confidentiality of the donors information. These are personal, fa-
milial or social details, which have the potential to discriminate or stigmatise the person.
A biobank is a link between two elements. On one side, there are the donors, sick or healthy in-
dividuals, on the other, there are the scientists who are researching, starting from the donors samples.
With the development of the biotechnologies and medical research, the role of the biobanks is
becoming greater and more important. This is raising some issues, one of them being the management.
Owing to the increasing interest in medical research and the benefic results concerning the
health, it is imperative to find practical solutions to the problems associated with the management of a
biobank: the protection of the researchers integrity, as well as the guarantee of the cofidentiality of the
data which brings the information.
Biobnci
1. Spitalul Clinic Municipal de Urgen Timioara; 2. Spitalul Clinic Judeean de Urgen
Timioara
Biobncile sunt colecii organizate de probe biologice i de date asociate acestora care sunt
colectate, stocate i procesate n scop tiinific.
Termenul de biobanc este relativ nou, el a aprut pentru prima dat n PubMed n 1996, dar
frecvena sa a nceput s creasc dup 2000.
Numrul acestora se ridic la cteva sute de milioane i crete n continuu i rapid.
La nceput fiecare biobanc era un suport pentru un program de cercetare care avea ca tem o
anumit boal i necesita studiul numai a unui anumit esut. Pentru a reduce costurile, astzi, biobn-
cile colecteaz mai multe tipuri de materiale biologice i date.
Biobanca trebuie s asigure confidenialitatea datelor donorului. Aceste date sunt de natur per-
sonal, familial sau social i au potenialul de a discrimina i stigmatiza persoana.
O biobanc este o legatur ntre dou medii. Pe de o parte sunt donatorii, fie ei bolnavi sau indi-
vizi sntoi, pe de cealalt parte sunt oamenii de tiin care fac cercetri plecnd de la aceste probe.
O dat cu dezvoltarea biotehnologiilor i a cercetrii medicale devine tot mai mare i mai im-
portant rolul biobncilor. Acestea ridic la rndul lor o serie de probleme. Una dintre ele este manage-
mentul .
O dat cu creterea interesului n cercetarea medical i a rezultatelor benefice care decurg de
aici asupra sntii, este imperativ a gsi soluii practice la problemele asociate managementului unei
biobnci: protejarea integritii cercettorilor la fel de bine ca i garantarea confidenialitii datelor
celor care aduc informaia.
P39. E-health
1. Timioara Districtual Emergency Hospital Clinics; 2. Timioara County Emergency
Hospital Clinics
Information Technology is everywhere around us. It is the one that developed the concept of e-
health.
This new system must not be considered as the saving answer which will repair the medical
system. Information and communication can only be tools in the process of rehabilitation of the
medical system.
E-health is nothing more than digital transformation of the medical practice, the highest class of
the medical industry. This way, even in the medical world, the Internet is becoming the last frontier.
Electronic resources of medical data are useful when they are accessible. Using these resources
means having the capacity to read, to use a computer, to search for information, to understand the
medical data, and to apply it in the context.
But all these are not enough. An understanding of science is needed. One must know how to find
that information, which will be the ground of a decision, in a multitude of information.
The necessary information, which e-health offers, must be understood, processed, and then used
in the process of making an informed decision.
The benefits and risks of e-health are unclear for the patients, and for the doctors as well. It is
expected that e-health will be an important part of preventing diseases, in making a medical decision
and in the management of chronic illnesses.
The modern patient is interested in his health, is asking for medical information and wants to be
a part of making the medical decision, all these increasing the development of e-health.
E-Sntate
1. Spitalul Clinic Municipal de Urgen Timioara; 2. Spitalul Clinic Judeean de Urgen
Timioara
Tehnologia informaiei este peste tot n jurul nostru. Ea este cea care a dezvoltat conceptul de e-
health.
Acest nou sistem aprut nu trebuie privit ca soluia salvatoare care va repara sistemul medical.
Informaia i comunicarea pot fi doar o unealt n procesul de reabilitare a sistemului medical.
E-health nu este nimic mai mult dect transformarea digital a practicii medicale, latura cea mai
elitist a industiei medicale. Internetul devine astfel i n domeniul medical ultima frontier.
Resursele electronice de informaii medicale sunt folositoare atunci cnd ai acces la ele. A folosi
aceste resurse necesit s ai capacitatea de a citi, de a folosi un computer, de a cuta informaii, de a n-
telege informaia medical i a pune-o n context.
Dar toate acestea nu sunt de ajuns. Este necesar o nelegere a tiinei. Trebuie s tii s gseti
acea informaie, care s fie baza unei decizii, ntr-o multitudine de informaii.
Informaia de care ai nevoie i pe care e-health i-o ofer, trebuie s fie neleas, procesat i
apoi folosit n procesul de luare a unei decizii informate.
Beneficiile i riscurile e-health-ului sunt neclare att pentru pacieni ct i pentru medici. Se as-
teapt ca e-health-ul s aib un cuvnt important de spus n prevenia bolilor, n alegerea unei decizii
medicale i n managementul bolilor cronice.
Pacientul modern e interesat de sntatea sa, cere informaie medical, vrea s participe la deciz-
ia medical, toate acestea nu fac dect s accentueze i mai mult dezvoltarea e-health-ului.
Posters 4. Biochemistry
P40. Clinico-biological screening of a diabetic juvenile population in order
to assess markers of periodontal injury
Foia Liliana1, Ungureanu Didona1, Dimitriu Cristina1, Toma Vasilica2, Zlei Mihaela3,
Anisiei Ecaterina3, Filip Florina4
1. Dept. of Biochemistry, University of Medicine and Pharmacy Gr. T. Popa, Iai; 2. Dept.
of Pedodoncy, University of Medicine and Pharmacy Gr. T. Popa, Iai; 3. Dept. of
Immunology and Genetics, Universitary Clinic Hospital Sf. Spiridon, Iai; 4. Dept. of
Family Medicine, University of Medicine and Pharmacy Gr. T. Popa, Iai
Introduction: Over the last years, there has been an emerging interest in the close relationship
between diabetes mellitus (DM) and oral health. In this view, the present study intended to scan the
activity of periodontal disease (PD) in a juvenile population with DM, through the monitoring of sol-
uble chemical mediators in the gingival crevicular fluid (GCF) and clinical index evaluation. Materials
and methods: Clinical (periodontal status) and laboratory investigations examining the interrelation
between DM and PD were performed upon 48, systemically healthy (n=24) and insulin-dependent dia-
betic (n=24) children and teenagers, both with various degrees of periodontal alteration. Triggered by
the hyperglycemic status of the diabetic patient, the synergistic inflammatory reactions modulated by
some released chemical mediators are probably the final cause of periodontal area destruction. Invest-
igation of the local (GCF) and systemic expression of the interleukin 1 and tumor necrotic factor -
TNF has been achieved by flow cytometry protocols. Results: The present study allowed identifica-
tion of some real immuno-biochemical disequilibrium in the diabetes - periodontal tissue injury. Cor-
relations between apoptotic potential of some cytokines with multivariable analysis suggest that clinic-
al attachment loss in diabetic individuals could be, at least partly attributed to higher levels of TNF
and IL-1 (pattern that has been evoked both at the periodontal and systemic level). Conclusions: Con-
sidering the increasing evidence that there is a bidirectional relationship between DM and PD, recogni-
tion and therapeutic manipulation of the immune system by targeted modulation of some specific cy-
tokines could be one of the premises in the diabetic child and teenager standard care. Key words: dia-
betes mellitus, periodontal disease, children and teenagers, gingival fluid, interleukin 1, tumor necrot-
ic factor .
Screening clinico-biologic ntr-o populaie tnr cu diabet zaharat pentru

determinarea unor markeri de afectare parodontal
Foia Liliana1, Ungureanu Didona1, Dimitriu Cristina1, Toma Vasilica2, Zlei Mihaela3,
Anisiei Ecaterina3, Filip Florina4
1. Dept. de Biochimie, UMF Gr. T. Popa, Iai; 2. Dept. de Pedodonie, UMF Gr. T.
Popa, Iai; 3. Dept. de Imunologie i Genetic, Spitalul Clinic Universitar Sf. Spiridon,
Iai; 4. Dept. de Medicin de Familie, UMF Gr. T. Popa, Iai
Introducere: n ultimii ani se nregistreaz un interes deosebit n aprecierea relaiei binomiale
dintre diabetul zaharat (DZ) i sntatea oral. n studiul de fa ne-am propus investigarea statusului
parodontal la o populaie tnr cu DZ, prin monitorizarea clinic i imunobiochimic (la nivel
sistemic i local). Material i metod: Examenul clinic (aprecierea statusului parodontal) i
investigaiile de laborator (n sangele periferic, i local n fluidul gingival - GCF) au fost realizate pe
dou loturi (48 copii i adolesceni), 24 fr afectare sistemic i 24 cu DZ, ambele cu variate grade de
alterare parodontal. Investigarea local i sistemic a rspunsului imunoinflamator generat n
contextul diabetic, a vizat dozarea interleukinei 1 (IL-1) i a factorului de necroz tumoral (TNF),
prin tehnici de flowcitometrie. Rezultate: Studiul de fa permite evaluarea dezechilibrului
imunobiochimic generat de afectarea esutului parodontal n contextul bolii diabetice. Corelaiile ntre
potenialul apoptotic al unora dintre citokine n cadrul analizei multivariabile sugereaz c pierderea de
ataament clinic la copiii i adolescenii cu DZ, poate fi, cel puin n parte, atribuit nivelului crescut de
TNF i IL-1 (aspect regsit att la nivel sistemic ct i local). Concluzii: Avnd n vedere
confirmarea prin studiul markerilor imunobiochimic la nivelul GCF, a interrelaiei DZ - boal
parodontal (BP), putem concluziona c recunoaterea i manipularea terapeutic a sistemului imun,
prin modularea intit a unor citokine specifice, poate constitui una din premizele standardului de
ngrijire la copilul i adolescentul diabetic. Cuvinte cheie: diabet zaharat, boal parodontal, copil i
adolescent, fluid gingival, interleukina 1, factorul de necroz tumoral.
P41. Markers of bone turnover in postmenopausal osteoporosis

Gurban Camelia1, Gotia Smaranda2, Gotia Laura2, Savescu Iasmina3, Ciacli Camelia4,
Puschita Maria4, Erdelean V.5, Sfrijan Felicia1
Romania; 2. Physiology Dept., Victor Babe University of Medicine and Pharmacy,
Timioara, Romania; 3. TST-SHS Dept., Banat University of Agricultural Sciences and
Veterinary Medicine, Timioara, Romania; 4. Immunology Dept., Faculty of Medicine,
Pharmacy and Dental Medicine, Vasile Goldi Western University, Arad, Romania; 5.
Municipal Clinical Hospital, Clinical Laboratory Department, Timioara, Romania
Aim: The aim of this study was to determine the serum levels of soluble receptor activator of
nuclear factor-kB ligand (sRANKL), osteoprotegerin (OPG), bone alkaline phophatase (BAP), osteo-
calcin (OC) and estradiol (E2) in the process of bone turnover of postmenopausal women with osteo-
porosis. Material and methods: The study was performed on two groups of patients with postmeno-
pausal osteoporosis, with different degrees of estrogenic deprivation: the group I (below 15 years of es-
trogenic deprivation) and the group II (over 15 years of estrogenic deprivation), compared with a con-
trol group (postmenopausal women without osteoporosis). The serum levels of the enunciated markers
were measured by ELISA technique. The bone mineral density evaluation was made using DEXA
methods with the assessment of T score (sT spine). Results: The serum levels of sRANKL are signific-
antly higher in postmenopausal women with osteoporosis and demonstrating osteoclastogenesis activa-
tion versus postmenopausal women without osteoporosis. The serum levels of OPG and OC in post-
menopausal women with osteoporosis were increased in group I, attesting the osteoblastic activation,
and decreased in group II, secondary to the stimulation of osteoblastic apoptosis. The serum levels of
BAP in postmenopausal women with osteoporosis were increased in group I and II, demonstrating the
osteoblastic activation. The serum levels of E2 are significantly lower in both groups, demonstrating a
decreased function of estrogen receptor ER and ER, expressed by osteoblasts. Conclusions: This un-
balance is producing a decrease of bone formation and an increase of bone resorting, being favorable to
bone demineralization. Key words: bone markers, bone turnover.
Markeri ai turnover-ului osos din osteroporoza postmenopauzal

1. Catedra de Biochimie, UMFVictor Babe, Timioara, Romnia; 2. Catedra de
Fiziologie, UMFVictor Babe, Timioara, Romnia; 3. Catedra TST-SHS, Universitatea de
tiine Agricole i Medicin Veterinar a Banatului, Timioara, Romnia; 4. Catedra de
Imunologie, Facultatea de Medicin, Farmacie i Medicin Dentar, Universitatea de Vest
Vasile Goldi, Arad, Romnia; 5. Laboratorul Clinic de Analize, Spitalul Clinic Municipal,
Timioara, Romnia
Scopul: Scopul acestui studiu este determinarea nivelelor serice ale ligand-ului solubil al re-
ceptorului activator al factorului nuclear kB (sRANKL), osteoprotegerina (OPG), fosfataza alcalin
specific osului (BAP), osteocalcina (OC) i estradiol (E2) implicai n turnover-ul osos din osteo-
poroza postmenopauzal. Materiale i metode: Studiul a fost efectuat pe 2 loturi de paciente cu osteo-
poroz postmenopauzal (n funcie de perioada de deprivare estrogenic): grupul I (mai puin de 15
ani deprivare estrogenic) i grupul II 2 (mai mult de 15 ani deprivare estrogenic), comparativ cu un
lot martor (paciente la menopauza fr osteoporoz). Nivelele serice ale acestor markeri s-au determin-
at prin tehnica imunoenzimatic ELISA. Densitatea mineral osoas se evalueaz utiliznd metoda
DEXA, cu msurarea scor-ului T la nivel vertebral (sT spine). Rezultate: Nivelele serice ale sRANKL
au fost semnificativ ridicate n osteoporoza postmenopauzal i demonstreaz activarea osteoclastogen-
ezei, comparativ cu femeile n postmenopauz fr osteoporoz. n osteoporoza postmenopauzal
nivelele serice ale OPG i OC sunt crescute (grupul I) demonstrnd activarea osteoblastelor i sunt
sczute (grupul II) demonstrnd stimularea apoptozei osteoblastelor. Nivelele serice crescute ale BAP
demostreaz activarea osteoblastelor n osteoporoza postmenopauzal (grupul I i II), prin creterea
turnover-ului osos. Nivelele serice ale E2 au fost semnificativ sczute la ambele grupuri i demon-
streaz reducerea activitii receptorilor estrogenici ER i ER, exprimai la nivel osteoblastic. Con-
cluzii: Acest dezechilibru produce o reducere a formrii osoase i o cretere a resorbiei osoase, favor-
iznd astfel demineralizarea osoas. Cuvinte cheie: markeri osoi, turnover-ul osos.
P42. Bone markers and calcium ions involved in bone remodeling at

postmenopausal osteoporosis
Romania; 2. Physiology Dept., Victor Babe University of Medicine and Pharmacy,
Timioara, Romania; 3. TST-SHS Dept., Banat University of Agricultural Sciences and
Veterinary Medicine, Timioara, Romania; 4. Immunology Dept., Faculty of Medicine,
Pharmacy and Dental Medicine, Vasile Goldi Western University, Arad, Romania; 5.
Municipal Clinical Hospital, Clinical Laboratory Department, Timioara, Romania
Objectives: To analyze if serum levels of bone alkaline phosphatase (BAP), osteocalcin (OC),
serum and bone levels of Ca(2+) are elevated at postmenopausal women with osteoporosis. Material
and methods: The serum levels of the BAP and OC were measured by ELISA technique, serum levels
of the Ca(2+) were measured by Vitros Ca Slides quantitative technique and bone levels of the Ca(2+)
were measured by the bone flame atomic absorption spectrometry analyzed (FAAS). Results: In cohort
1: BAP were 13.760.6 g/ml, OC were 20.120.87 ng/ml, serum levels of Ca(2+) were 5.390.08
mg/dl and bone levels of Ca(2+) were 10.650.03 mg/g of bone. In cohort 2: BAP were 11.880.38 g/
ml, OC were 15.121.55 ng/ml, serum levels of Ca(2+) were 4.120.05 mg/dl and bone levels of
Ca(2+) were 11.630.14 mg/g of bone. In control group: BAP were 8.680.44 g/ml, OC were
16.221.62 ng/ml, serum levels of Ca(2+) were 4.840.08 mg/dl and bone levels of Ca(2+) were
14.240.13 mg/g of bone. Conclusions: The increased serum levels of BAP demonstrate osteoblasts
activation, which will increase significantly bone remodeling (cohort 1 and 2). Increased serum levels
of OC demonstrates osteoblasts activation (cohort 1), and decreased serum levels of OC demonstrates
osteoblasts apoptosis stimulation (cohort 2), associated with estrogen deficiency postmenopausal in-
stalled. The serum levels of Ca(2+) transitory increase as a result of bone demineralization through
hidroxiapatite microcrystal solubilization and mobilization of those ions in the circulating torrents. De-
creased calcium ions at bone level have as a consequence localized bone demineralization accentuation
encouraging the appearance of osteoporosis bone microfractures.
Markerii osoi i ionii de calciu implicai n remodelarea osoas n

osteoporoza postmenopauzal
1. Catedra de Biochimie, UMFVictor Babe, Timioara, Romnia; 2. Catedra de
Fiziologie, UMFVictor Babe, Timioara, Romnia; 3. Catedra TST-SHS, Universitatea de
tiine Agricole i Medicin Veterinar a Banatului, Timioara, Romnia; 4. Catedra de
Imunologie, Facultatea de Medicin, Farmacie i Medicin Dentar, Universitatea de Vest
Vasile Goldi, Arad, Romnia; 5. Laboratorul Clinic de Analize, Spitalul Clinic Municipal,
Timioara, Romnia
Obiective: Analizarea nivelelor serice ale fosfatazei alcaline osoase (BAP), osteocalcinei (OC),
nivelelor serice i osoase ale ionilor de calciu, Ca(2+) sunt importante la femeile n postmenopauz cu
osteoporoz. Materiale i metode: Nivelele serice ale BAP i OC sunt msurate prin tehnica ELISA,
nivelele serice ale Ca(2+) sunt msurate prin tehnica biochimic colorimetric uscat, Vitros Ca, iar
nivelele osoase ale ionilor Ca(2+) sunt msurate prin tehnica spectrofotometriei de absorbie atomic
(FAAS). Rezultate: La lotul 1: BAP a fost 13.760.6 g/ml, OC a fost 20.120.87 ng/ml, nivelele
serice ale Ca(2+) au fost 5.390.08 mg/dl i nivelele osoase ale Ca(2+) au fost 10.650.03 mg/g os. La
lotul 2: BAP a fost 11.880.38 g/ml, OC a fost 15.121.55 ng/ml, nivelele serice Ca(2+) au fost
4.120.05 mg/dl i nivelele osoase ale Ca(2+) au fost 11.630.14 mg/g os. La grupul control: BAP a
fost 8.680.44 g/ml, OC a fost 16.221.62 ng/ml, nivelele serice ale Ca(2+) au fost 4.840.08 mg/dl
i nivelele osoase ale Ca(2+) au fost 14.240.13 mg/g os. Concluzii: Nivelele serice crescute ale BAP
demonstreaz activarea osteoblastelor, cu o cretere semnificativ a remodelrii osoase (lotul 1 i 2).
Nivelele serice crescute ale OC demonstreaz activarea osteoblastelor (lotul 1), iar nivelele serice
sczute ale OC demonstreaz stimularea apoptozei osteoblastelor (lotul 2), asociate cu deficitul estro-
genic instalat postmenopauzal. Nivelele serice ale Ca(2+) crescute tranzitoriu ca rezultat al demineral-
izrii osoase prin solubilizarea microcristalelor de hidroxiapatit i mobilizarea lor n torentul circulat-
or. Ionii Ca(2+) scad la nivel osos ca o consecin demineralizrii osoase localizate, favoriznd apariia
de microfracturi osoase osteoporotice.
P43. The osteoprotegerin and bone alkaline phosphatase - immunological

markers of osteosynthesis in psoriatic arthritis
Ciacli Camelia1, Gligor Ramona2, Gurban Camelia3, Sitariu Anca4
1. Dept. of Immunology, Faculty of Medicine, Pharmacy and Dental Medicine, Vasile
Goldi Western University, Arad; 2. Dept. of Biochemistry, Faculty of Medicine, Pharmacy
and Dental Medicine, Vasile Goldi Western University, Arad; 3. Dept. of Biochemistry,
University of Medicine and Pharmacy Victor Babe, Timioara; 4. Faculty of Medicine,
Pharmacy and Dental Medicine, Vasile Goldi Western University, Arad student
Introduction: In our study we evaluated the blood concentration of osteoprotegerin (OPG) and
bone alkaline phosphatase (bone-ALP) in psoriatic arthritis. Material and methods: Our study was
made on two patient groups. Group 1 consisting of 27 patients diagnosed with psoriatic arthritis based
on CASPAR criteria, group 2 consisting of 21 patients diagnosed with rheumatoid arthritis, based on
ARA criteria and the control group (healthy patients). The OPG and bone-ALP serum levels were
quantified by sandwich Elisa immunoenzimatic assay. Results and disscussion: In psoriatic arthritic
patients, the OPG (p1<0.003 - statistically very important) and bone-ALP (p2<0.002 - statistically very
important) serum level increases more than in normal individuals, but there are more reduced at pa-
tients with rheumatoid arthritis which corresponds with clinic reality of bone synthesis that is trying to
counteract the bone distruction in those disorders.The increase in OPG and Bone-ALP serum level in-
duces the production of bone matrix parallel to the bone destruction mediated by RANKL. Conclu-
sions: Our study proves that the OPG and bone-ALP represents a marker for the activation of osteosyn-
thesis, which takes place in bone remodeling process in psoriatic arthritis. The monitoring of psoriatic
arthritis patients by early determination of OPG and bone-ALP serum levels, bone metabolism marker
(have specific role in bone remodeling), allows a precise evaluation of the disease activity, and, in the
future, could be a criteria for initializing the specific, targeting therapy. Keywords: osteosynthesis, os-
teoprotegerin, bone alkaline phosphatase, psoriatic.
Osteoprotegerina i fosfataza alcalin osoas - markeri imunologici ai

osteosintezei n artrita psoriazic
Ciacli Camelia1, Gligor Ramona2, Gurban Camelia3, Sitariu Anca4
1. Dept. de Imunologie, Facultatea de Medicin, Farmacie i Medicin Dentar,
Universitatea de Vest Vasile Goldi, Arad; 2. Dept. de Biochimie, Facultatea de Medicin,
Farmacie i Medicin Dentar, Universitatea de Vest Vasile Goldi, Arad; 3. Dept. de
Biochimie, UMFVictorBabe, Timioara; 4. Facultatea de Medicin, Farmacie i Medicin
Dentar, Universitatea de Vest Vasile Goldi, Arad - student
Obiective: n acest studiu am evaluat nivelul sangvin al markerilor osteosintezei respectiv, os-
teoprotegerina (OPG) i fosfataza alcalin osoas (FA-osoas) la pacienii cu artrit psoriazic. Mater-
ial i metod: n studiu au fost inclui 27 pacieni cu artrit psoriazic diagnosticai pe baza criteriilor
CASPAR (lotul 1), 21 pacieni cu artrit reumatoid diagnosticai pe baza criteriilor ARA (lotul 2) i
20 voluntari sntoi (lotul 3). Nivelul sangvin al osteoprotegerinei i cel al fosfatazei alcaline osoase a
fost cuantificat prin metoda ELISA. Rezultate: n urma studiului inteprins de noi s-a evideniat
creterea important a concentraiei serice a osteoprotegerinei (p1<0.003 - intens semnificativ statistic)
i a fosfatazei alcaline osoase (p2<0.002 - intens semnificativ statistic) la pacienii cu artrit psoriazic
comparativ cu martorii sntoi, ns mai redus dect la pacienii cu artrit reumatoid ceea ce
corespune cu realitatea clinic a sintezei osoase care ncearc s contracareze distrucia osoas din
cadrul acestor afeciuni. Creterea concentraiei serice a osteoprotegerinei i a fosfatazei alcaline
osoase reprezint markeri ai sintezei osoase crescute care are loc n artrita psoriazic. Concluzii: Stu-
diul nostru a demonstrat c cei doi markeri ai osteosintezei, osteoprotegerina i fosfataza alcalin
osoas reprezint markeri osteogeni ai remodelrii osoase cu prevalen ai sintezei osoase i ei au o
valoare orientativ asupra procesului de osteosintez din artrita psoriazic, o valoare prognostic i ap-
licabilitate clinic n depistarea pacienilor care pot beneficia precoce de terapie specific naintea apar-
iiei complicaiilor. Cuvinte cheie: osteosinteza, artrita psoriazic, osteoprotegerina seric, fosfataza
alcalin seric.
P44. Importance of the determination of bone alkaline phosphatase in

postmenopausal osteoporosis
Bonte Diana Camelia1, David Dana Liana1, Lighezan Rodica2, Zosin Ioana3, Anghel
Andrei1
1. Biochemistry Dept, Victor Babe University of Medicine and Pharmacy, Timioara; 2.
Histology Dept., Victor Babe University of Medicine and Pharmacy, Timioara; 3.
Endocrinology Dept., Victor Babe University of Medicine and Pharmacy, Timioara
Introduction: Bone alkaline phosphatase (BAP) is an enzyme which plays an important role in
the bone formation and in mineralization. It reflects the metabolic status of osteoblasts. Objectives: to
determine the usefulness of the BAP measurement in serum for the monitoring of the therapy effi-
ciency in osteoporosis patients. Materials and method: The study included a group of 34 patients suf-
fering from postmenopausal osteoporosis, confirmed by DEXA (group 1), undergoing a treatment with
bisphophonates, and a control group (2): 20 postmenopausal women, not suffering from osteoporosis.
The serum level of BAP was evaluated for both groups (ELISA), at the beginning of the study, then
after 6 and 12 months. The efficiency of the therapy for the study group was evaluated according to the
DEXA method, after 12 months of treatment. Results: BAP0/6/12 ( g/L) - group 1: 15.6669
5.967184 / 12.56637 3.536284 / 12.2017 3.302395. BAP0/12 ( g/L) - group 2: 12.1893 3.15364 /
12.16475 3.26375. Discussion: The initial BAP values were significantly higher in osteoporosis pa-
tients. A highly significant negative correlation was established between the values of BAP and the
BMD (p=0.01). In patients where the BMD was high (but under treatment), the BAP values showed a
significant decrease at 6 months and they continued to decrease until the following measurement. Con-
clusions: The BAP measurement reflects the changes at the level of the bone remodelling due to the
anti-osteoporosis treatment. The significant decrease of the BAP levels after 6 months proves the effi-
ciency of the treatment.
Importana determinrii fosfatazei alcaline cu specificitate osoas n

osteoporoza postmenopauzal
Bonte Diana Camelia1, David Dana Liana1, Lighezan Rodica2, Zosin Ioana3, Anghel
Andrei1
1. Catedra de Biochimie, UMFVictor Babe Timioara; 2. Catedra de Histologie,
UMFVictor Babe Timioara; 3. Catedra de Endocrinologie, UMFVictor Babe
Timioara
Introducere: Fosfataza alcalin cu specificitate osoas (FAos.) este o enzim care joac un rol
important n formarea osoas i n mineralizare. Ea reflect statusul metabolic al osteoblastelor.
Obiectivele: stabilirea utilitii determinrii FAos. din ser n urmrirea eficienei terapiei la pacientele
cu osteoporoz. Material i metod: Studiul a inclus un lot de 34 paciente cu osteoporoz postmeno-
pauzal, validat prin DEXA (lot 1), care au urmat un tratament cu bifosfonai i un lot control de 20
de femei n postmenopauz (lot 2), fr osteoporoz. La ambele loturi se analizeaz nivelul seric al
FAos (tehnica ELISA) la momentul iniial al inceperii studiului, la 6 i la 12 luni. Analizarea eficienei
terapiei antiosteoporotice la lotul de studiu s-a realizat prin metoda DEXA, dup 12 luni de tratament.
Rezultate: BAP0/6/12 ( g/L) - lot 1: 15.6669 5.967184 / 12.56637 3.536284 / 12.2017
3.302395. BAP0/12 (g/L) - lot 2: 12.1893 3.15364 / 12.16475 3.26375. (Valori normale medii
premenopauz: 8.7/ postmenopauz: 12.2). Discuii: Valorile FAos. au fost semnificativ crescute la pa-
cientele cu osteoporoz, la determinarea iniial. Ulterior, am constatat o corelaie negativ foarte im-
portant ntre valorile acestui marker de formare osoas i DMO (p=0.01). La pacientele cu cretere a
DMO (sub tratament), valorile FAos. au prezentat o scdere accentuat la 6 luni de la iniierea terapiei
i au continuat s scad pn la urmtoarea determinare. Concluzii: Determinarea FAos. este util, re-
flectnd schimbrile la nivelul remodelrii osoase datorate terapiei antiosteoporotice. Scderile semni-
ficative ale FAos. la 6 luni arat eficiena tratamentului.
P45. The value of bone resorption markers in monitoring treated

osteoporosis
Bonte Diana Camelia1, David Dana Liana1, Lighezan Rodica2, Motoc Marilena1, Zosin
Ioana3, Bonte Ovidiu Horia4
1. Biochemistry Dept., Victor Babe University of Medicine and Pharmacy, Timioara; 2.
Histology Dept. Victor Babe, University of Medicine and Pharmacy, Timioara; 3.
Endocrinology Dept., Victor Babe, University of Medicine and Pharmacy, Timioara; 4.
Dept. of In vitro Fertilization of the Gynecology and Obstetrics Hospital Dr. Dumitru
Popescu, Timioara
Introduction Pyridinoline and deoxypyridinoline are the crosslinks of mature type I collagen in
bone, being released from bones during collagen degradation, and finally eliminated in urine. Object-
ives: to determine a correlation between the values of urinary pyridinoline (PYD), bone mineral density
(BMD), the values of serum calcium and the values of serum phosphorus. Materials and methods:
The study group included 30 patients (group 1) suffering from postmenopausal osteoporosis (undergo-
ing treatment) and the control group of 20 postmenopausal patients, not suffering from osteoporosis
(group 2). They underwent a basic examination: measurement of BMD (DEXA at L 1L4 and at the
hip), of urinary pyridinoline levels (ELISA) and of serum levels of calcium and phosphorus. The urin-
ary pyridinoline assessments were repeated 6 and 12 months after the initial moment, while serum cal-
cium, phosphorus and DEXA were repeated after 12 months. Results: PYD0/6/12 months (nmol/mmol creat-
inine): 52.57 19.92 / 32.61 11.91 / 28.90 12.23 (group 1), PYD0/12 months: 26.02 10.15 / 29.34
10.72 (group 2). Discussion: A significant negative correlation between the levels of pyridinoline and
the bone mineral density was reported. In patients where the BMD registered an increase (due to the
treatment), the urinary pyridinoline showed a significant decrease 6 months after the beginning of treat-
ment. The serum calcium and phosphorus levels were relatively constant during the study. Conclu-
sions: The evaluation of the urinary pyridinoline levels is useful for clinicians to assess the efficacy of
the treatment in osteoporosis patients, much before assessing the BMD.
Valoarea markerilor de resorbie osoas n monitorizarea osteoporozei sub

tratament
Bonte Diana Camelia1, David Dana Liana1, Lighezan Rodica2, Motoc Marilena1, Zosin
Ioana3, Bonte Ovidiu Horia4
1. Catedra de Biochimie, UMFVictor Babe Timioara; 2. Catedra de Histologie,
UMFVictor Babe Timioara; 3. Catedra de Endocrinologie, UMFVictor Babe
Timioara; 4. Laboratorul de Fertilizare Asistat Medical, Spitalul Clinic Dr. Dumitru
Popescu, Timioara
Introducere: Dou legturi majore sunt prezente n matricea osoas i n cartilaj (legturi ce
stabilizeaz fibrele de colagen): piridinoline i deoxipiridinoline PYR. Ele sunt eliberate din os n
cursul degradrii colagenului, de unde ajung n urin. Obiectivele: stabilirea unei corelaii ntre valorile
piridinolinelor urinare (PYR), densitatea mineral osoas (DMO), valorile serice ale calciului i fosfor-
ului anorganic. Material i metod: Lotul a cuprins un grup de 30 de paciente (grup 1) cu osteoporoz
de postmenopauz (cu tratament) i un grup-control de 20 de paciente n postmenopauz, dar fr os-
teoporoz (grup 2). Acestora li s-a facut o evaluare bazal: msurarea DMO (DEXA-vertebrele L1L4
i old), a nivelurilor piridinolinelor urinare (ELISA) i a valorilor serice ale calciului i fosforului an-
organic. Determinrile piridinolinelor urinare s-au repetat la 6 i la 12 luni de la momentul iniial, cal-
ciul, fosforul i DEXA au fost repetate dup 12 luni. Rezultate: PYD0/6/12 luni (nmol/mmol creatinina):
52.57 19.92 / 32.61 11.91 / 28.90 12.23 (grup 1); PYD0/12 luni: 26.02 10.15 / 29.34 10.72 (grup
2). Discuii: Am constatat o corelaie negativ foarte semnificativ ntre valorile markerilor de resor-
bie (piridinolinele) i DMO. La pacientele cu cretere a DMO (sub tratament), eliminarea urinar a
piridinolinelor a prezentat o scdere important nc de la 6 luni de la iniierea tratamentului. Valorile
calciului i ale fosforului seric au fost relativ constante pe parcursul studiului. Concluzii: Determinarea
piridinolinelor urinare este util pentru clinician n aprecierea eficienei terapiei la pacientele cu osteo-
poroz, cu mult nainte de evaluarea DMO.
P46. Low serum bilirubin levels, predictors of developing atherosclerosis

Borza Claudia1, Savoiu Germaine2, Cristescu Carmen3, erban Corina1, Duicu Oana1,
Ghete Mihaela4, Mateescu Rodica5
1. Pathophysiology Dept., University of Medicine and Pharmacy Victor Babe Timioara;
2. Anatomy Physiology and Pathophysiology Dept., University of Medicine and Pharmacy
Victor Babe, Timioara; 3. Dept. of Clinical Pharmacy, University of Medicine and
Pharmacy Victor Babes, Timioara; 4 Bioexpomed Laboratory, Timioara; 5. Physiology
Dept.,
Aim: Bilirubin prevents oxidative modification of LDL and may protect from atherosclerosis
and arterial hypertension. Impaired brachial artery flow-mediated dilatation (FMD), which means en-
dothelial dysfunction is a strong predictor for the development and progression of atherosclerosis. The
aim of this study was to analyze the association between low serum bilirubin levels with impaired flow
mediated dilatation in a group of 103 hypertensive patients. Material and method: We determined by
fully enzymatic techniques: triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol and ser-
um bilirubin levels in all patients. Brachial artery flow-mediated dilatation was measured by means of
high-resolution vascular ultrasound B-mode. Results: We observed significantly higher plasma levels
of total cholesterol (231.32 27.56 mg/dl), LDL-cholesterol (162.52 30.55 mg/dl), triglycerides
(168.15 52.05 mg/dl) and low plasma levels of HDL-cholesterol (36.23 5.90 mg/dl) in all patients.
We noticed low serum levels of total bilirubin (0.67 0.08 mg/dl), direct bilirubin (0.20 0.05 mg/dl)
and indirect bilirubin (0.47 0.07 mg/dl) and FMD was also decreased (9.8 0.8%). We have done the
statistically analysis with Pearsons test which indicated inverse correlations between low serum total
bilirubin, direct bilirubin and indirect bilirubin levels and impaired flow-mediated vasodilatation. Con-
clusion: In this study we have shown that lower serum bilirubin concentrations are independently and
inversely associated with an increased risk for developing atherosclerosis. This finding is important be-
cause it may imply a tendency to enhanced atherosclerosis in subjects with lower serum bilirubin con-
centrations and arterial hypertension. Keywords: bilirubin, FMD, arterial hypertension, atherosclero-
sis.
Nivelele sczute ale bilirubinei serice, predictori ai dezvoltrii aterosclerozei

Borza Claudia1, Savoiu Germaine2, Cristescu Carmen3, erban Corina1, Duicu Oana1,
Ghete Mihaela4, Mateescu Rodica5
1. Dept. de Fiziopatologie, UMFVictor Babe Timioara; 2. Dept. de Anatomie, Fiziologie
i Fiziopatologie, Facultatea de Farmacie, UMFVictor Babe Timioara; 3. Dept. de
Farmacie Clinic, UMFVictor Babe, Timioara; 4. Laboratorul de analize Bioexpomed,
Timioara; 5. Dept. de Fiziologie, UMFVictor Babe, Timioara
Scop: Bilirubina previne modificarea oxidativ a LDL i poate proteja mpotriva aterosclerozei
i hipertensiunii arteriale. Scderea vasodilataiei mediate de flux la nivelul arterei brahiale (FMD),
care semnific disfuncie endotelial, este un puternic predictor al dezvoltrii i progresiei atero-
sclerozei. Scopul acestui studiu a fost s analizm asocierea dintre nivelele sczute de bilirubin seric
i cele ale vasodilataiei mediate de flux la un lot de 103 pacieni hipertensivi. Material i metod:
Am determinat la toi pacienii, prin metode imunoenzimatice complexe: trigliceridele, colesterolul
total, LDL-colesterolul, HDL-colesterolul i nivelele de bilirubin seric. Vasodilataia mediat de flux

a fost evaluat folosind ultrasonografia vascular, de nalt rezoluie, de tip B. Rezultate: Am observat
la toi pacienii nivele plasmatice crescute ale colesterolului total (231.32 27.56 mg/dl), LDL-coles-
terolului (162.52 30.55 mg/dl), trigliceridelor (168.15 52.05 mg/dl) i nivele plasmatice sczute ale
HDL-colesterolului (36.23 5.90 mg/dl). Am obinut nivele plasmatice sczute ale bilirubinei totale
(0.67 0.08 mg/dl), bilirubinei directe (0.20 0.05 mg/dl), ale bilirubinei indirecte (0.47 0.07
mg/dl), iar valoarea medie a FMD a fost de asemenea sczut (9.8 0.8%). Am efectuat analiza statist-
ic cu ajutorul testului Pearson care ne-a indicat corelaii inverse ntre bilirubina seric total, direct i
indirect i valorile vasodilataiei mediate de flux. Concluzii: n acest studiu am demonstrat c nivelele
sczute ale bilirubinei serice sunt independent i invers asociate cu un risc crescut de a dezvolta atero-
scleroza. Aceasta observaie este important deoarece ar putea implica o tendin crescut la atero-
scleroz la pacienii cu nivele sczute ale bilirubinei i hipertensiune arterial. Cuvinte cheie: biliru-
bin, hipertensiune arterial, ateroscleroz.
P47. Higher serum uric acid levels are associated with atherogenesis
independent from hypertension
Borza Claudia1, Savoiu Germaine2, Cristescu Carmen3, Noveanu Lavinia4, erban
Corina1, Duicu Oana1, Rducan Andreea1, Ghete Mihaela5
1. Pathophysiology Dept., University of Medicine and Pharmacy Victor Babe, Timioara;
2. Anatomy, Physiology and Pathophysiology Dept., University of Medicine and Pharmacy
Victor Babe, Timioara; 3. Dept. of Clinical Pharmacy, University of Medicine and
Pharmacy Victor Babe Timioara; 4. Physiology Dept., University of Medicine and
Pharmacy Victor Babe Timioara, 5. Bioexpomed Laboratory, Timioara
Aim: Hyperuricemia (HU) is a well recognized risk factor for cardiovascular diseases. Intima-
media thickness (IMT) of the carotid artery assessed noninvasively by ultrasonography is now valid-
ated as a sensitive marker for atherosclerosis and it is directly associated with increased risk of cardi-
ovascular disease. The aim of this study was to evaluate the correlations between IMT and uric acid
levels in patients with hypertension (HT). Material and methods: Our study consisted of: a group of
30 patients with HT without HU (male 58%, mean age SD: 4910 years), a group of 25 patients with
HT and HU (male 52%, mean age SD: 5210 years), and a control group of 25 healthy subjects
(male 55%, mean age SD: 5011 years). All patients in the study groups were complete clinically
and paraclinically investigated. All the patients were examined by high resolution B-mode ultrasound
to measure the IMT of the common carotid artery. Results: IMT values were significantly higher in the
hypertensive patients groups with and without HU, compared with the control group (0.980.28,
1.410.31 versus 0.560.15 mm, respectively, p<0.001). All patients with HU had significantly higher
carotid IMT compared with the patients without HU. Conclusion: In this study we have shown that
higher serum uric acid levels are associated with atherogenesis independent from hypertension. There-
fore, early screening for hyperuricemia is recommended in hypertensive patients. Lowering serum uric
acid levels might be beneficial in slowing progression of IMT in hypertensive patients. Keywords: hy-
peruricemia, intima-media thickening, atherosclerosis.
Nivelele serice crescute de acid uric sunt asociate cu aterogeneza

independent de hipertensiune
Borza Claudia1, Savoiu Germaine2, Cristescu Carmen3, Noveanu Lavinia4, erban
Corina1, Duicu Oana1, Rducan Andreea1, Ghete Mihaela5
1. Dept. de Fiziopatologie, UMFVictor Babe,Timioara; 2. Dept. de Anatomie, Fiziologie
i Fiziopatologie, Facultatea de Farmacie, UMFVictor Babe, Timisoara; 3. Dept. de
Farmacie Clinic, UMFVictor Babe, Timioara; 4. Dept. de Fiziologie, UMFVictor
Babe, Timioara; 5. Laboratorul de analize Bioexpomed, Timioara
Scop: Hiperuricemia este un factor de risc recunoscut pentru boala cardiovascular. Grosimea
complexului intima-media la nivelul arterei carotide (IMT), evaluat noninvaziv prin ultrasonografie
este acum validat ca fiind marker sensibil al aterosclerozei, fiind direct asociat cu risc crescut de
boal cardiovascular. Scopul studiului este evaluarea corelaiilor dintre nivelele IMT i nivelele acidu-
lui uric seric la pacienii hipertensivi. Material i metod: Studiul a fost alctuit din: un grup de 30 de
pacieni cu hipertensiune i fr hiperuricemie (58% brbai, vrsta medie SD: 4910 ani), un grup
de 25 de pacieni cu hipertensiune arterial i hiperuricemie (52% brbai, vrsta medie SD: 5210
ani) i un grup de control format din 25 de subieci sntoi (55% brbai, vrsta medie SD: 5011
ani). Pacienii cuprini n studiu au fost complet investigai clinic i paraclinic i examinai prin ultra-
sonografie de nalt rezoluie tip B, pentru msurarea grosimii complexului intima-media la nivelul
arterei carotide comune. Rezultate: Valorile IMT au fost semnificativ mai mari la grupul de pacieni
cu hipertensiune arterial i fr hiperuricemie comparativ cu grupul control (0.980.28, 1.410.31
versus 0.560.15 mm, respectiv, p<0.001). Toi pacienii cu hiperuricemie au avut valoarea IMT sem-
nificativ mai mare comparativ cu lotul fr hiperuricemie. Concluzii: n acest studiu am artat c val-
orile crescute ale acidului uric seric sunt asociate cu aterogeneza independent de hipertensiune. Aadar,
este recomandat un screening precoce pentru hiperuricemie la pacienii hipertensivi. Scderea nivelelor
acidului uric seric ar putea fi benefic pentru ncetinirea progresiei grosimii intima-media carotidian la
pacienii cu hipertensiune arterial. Cuvinte cheie: hiperuricemie, grosimea intima-media carotidian,
ateroscleroz.
P48. Study on fibrinogen role in atheromatous plaque development at

elderly patients
Opri Simona, Constantin Gianina, Valuch Anton, Ginaru Cecilia
Ana Aslan National Institute of Gerontology and Geriatrics
High fibrinogen concentrations in cardiovascular diseases led to the idea that fibrinogen is an in-
dependent risk factor. However, little is known about the biochemical mechanism of age-related fib-
rinogen increase. Its concentration measurement could give important information about a potential as-
sociation between high plasmatic levels of this protein and aging. We took in study 2 age groups:
group 45-64 years with subgroups: control C1 and carotidian atherosclerosis ATS1; and group 65-84
years with subgroups: control C2 and carotidian atherosclerosis ATS2 and a group carotidian athero-
sclerosis ATS3 (45-84 years) with advanced stenosis (70-90%) assessed by Doppler ultrasonography.
Fibrinogen concentrations were measured with optic coagulometer by Clauss method. Our data showed
a statistical significant increased of 26,71%, at ATS1 vs. C1 (p<0.05), the same for ATS2 vs. C2 of
45% (p<0.001). From the point of view of total atheromatous area we observed a highly semnificative
rise at ATS1 and ATS2 vs. ATS3 of 190,03% and respectively 168,17%. Linear equation regression
showed a strong correlation between fibrinogen and total atheromatous area at ATS3 (r=0,536; p<0.05)
Relation between aging and fibrinogen revealed a nonsemnificative increase both at control and athero-
sclerosis patients too. The study results suggest that possible alterations of fibrinogen levels are associ-
ated with atherosclerosis. Fibrinogen, as a marker for chronic inflammatory process, who reflects ath-
erogenesis, could play an active role in atheromatous plaque development and progression.
Studiu privind rolul fibrinogenului n progresia leziunilor ateromatoase la

pacienii vrstnici
Opri Simona, Constantin Gianina, Valuch Anton, Ginaru Cecilia
Institutul Naional de Gerontologie i GeriatrieAna Aslan
Concentraiile crescute de fibrinogen n bolile cardiovasculare au condus la ideea c fibrinogenul
este un factor de risc independent. Se cunosc ns puine despre mecanismul biochimic al creterii
fibrinogenului cu vrsta. Msurarea concentraiei fibrinogenului ar putea da informaii importante
despre o potenial asociere ntre nivelele plasmatice crescute ale acestei proteine i mbtrnirea. S-au
luat n studiu 2 grupe de vrst: grupul 45-64 ani cu loturile: control C1 i cu ateroscleroz carotidian
ATS1 i grupul 65-84 ani cu loturile: control C2 i cu ateroscleroz carotidian ATS2 n plus, un lot
ATS3 (45-84 ani) cu grad de stenoz avansat (70-90%) evideniate prin Doppler carotidian. S-a deter-
minat concentraia de fibrinogen cu un coagulometru optic, utiliznd metoda Clauss. Datele noastre au
evideniat o cretere semnificativ statistic de 26,71%, la ATS1 vs. C1 (p<0.05) ct i la ATS2 vs. C2
de 45% (p<0.001). Din punct de vedere al ariei totale de ateroame se observ o cretere nalt semnifica-
tiv la ATS1 i ATS2 fa de ATS3 de 190,03% i respectiv 168,17%. Ecuaia de regresie liniar a ar-
tat o corelaie puternic ntre nivelele de fibrinogen i aria total a ateroamelor la lotul ATS3 (r=0,536;
p<0.05). Relaia dintre mbtrnire i fibrinogen arat o scdere nesemnificativ att la lotul control ct
i la pacienii cu ateroscleroz. Rezultatele studiului sugereaz c posibilele alterri ale nivelelor de fi-
brinogen sunt asociate cu ateroscleroza. Fibrinogenul ca marker pentru procesele cronice inflamatorii
ce reflect aterogeneza ar putea juca un rol activ n dezvoltarea i progresia leziunilor ateromatoase.
P49. Total antioxidant status in the blood serum of rats exposed to biogenic
amines
Zamoteanu Nina1, Filip Cristiana1, Albu Elena2, Albu Irina1, Cuciureanu Rodica3
1. Dept. of Biochemistry, Faculty of Medicine, Gr. T. Popa University of Medicine and
Pharmacy Iai; 2. Dept. of Pharmacology, Faculty of Medicine, Gr. T. Popa University of
Medicine and Pharmacy, Iai; 3. Dept. of Environment and Food Chemistry, Faculty of
Pharmacy, Gr. T. Popa University of Medicine and Pharmacy, Iai
Biogenic amines are endogenous compounds, which in high concentration become toxic and
there are responsible for major human disorders such as depression and schizophrenia, hypo- or hyper-
tension, headache and nausea. The exact mechanism by which biogenic amines cause these diseases in
not exactly known, but it is supposed that the total antioxidant status (TAS) of the organism is influ-
enced. The aim of our study was to investigate the influence of biogenic amines levels on total antiox-
idative status. For this, we worked on three series of Wistar male rats. Series I was control and received
no substance, series II received histamine (10mg/kg body) intraperitoneal (i.p.), single dose, and series
III received tyramine (5mg/kg body) intraperitoneal (i.p.), single dose. At 72 hours after biogenic
amines administration blood samples were collected and TAS was determined using a RANDOX kit
for manual use. Our data show that total antioxidant status present a significant decrease after 72 hours
after amines administration as compared with control series. The histamine and tyramine decreased the
level of the total oxidant status in rat blood serum and reduced the capacity of the antioxidant defense
system.
Influena aminelor biogene asupra statusului oxidativ general la obolani

Zamoteanu Nina1, Filip Cristiana1, Albu Elena2, Albu Irina1, Cuciureanu Rodica3
1. Disciplina de Biochimie, Facultatea de Medicin, Universitatea de Medicin i Farmacie
Gr.T.Popa, Iai; 2. Disciplina de Farmacologie, Facultatea de Medicin, Universitatea de
Medicin i Farmacie Gr.T.Popa, Iai; 3, Disciplina Chimia Mediului i Alimentului,
Facultatea de Farmacie, Universitatea de Medicin i Farmacie Gr.T.Popa, Iai
Aminele biogene sunt compui endogeni toxici n concentraii ridicate i responsabili de unele
afeciuni cum ar fi depresia i schizofrenia, hipo- sau hiper-tensiune, migrene, grea. Mecanismul prin
care aceste afeciuni sunt cauzate de aminele biogene nu este cunoscut n totalitate, dar se presupune c
ele influeneaz statusul total antioxidant (TAS) al organismului. Scopul studiului de fa este s
investigm dac aminele biogene influeneaz nivelul statusului total antioxidant al organismului.
Studiul experimental a fost realizat pe trei loturi de obolani Wistar. Lotul I a fost martor i nu a primit
amine biogene, lotul II a primit histamin (10mg/kg corp) intraperitoneal (i.p.) doz unic i lotul III a
primit tiramin (10mg/kg corp) intraperitoneal (i.p.) doz unic. La 72h dup administrarea
substanelor au fost recoltate probe de snge n care a fost determinat TAS utiliznd un kit RANDOX.
Rezultatele obinute arat c valoarea statusului total antioxidant prezint o scdere semnificativ dup
72h de la administrarea aminelor biogene comparativ cu lotul martor. Histamina i tiramina scad
nivelul seric al statusului total antioxidant la obolani i reduc capacitatea sistemului de protecie
antioxidant.
P50. Sialic acid and oxidated LDL studies in senescence

Constantin Gianina Ioana, Opri Simona
"Ana Aslan" National Institute of Gerontology and Geriatrics
As the sialic acid content of LDL affects its catabolism at the cellular level, it could be assumed
that the content is also associated with LDL metabolism in vivo. Aim of this study was to assess oxid-
atively modified lipoproteins and sialic acid in a group of presenescent (55.945.67 years), versus a
group of senescent patients (72.635.8 years) who were enrolled according to the Seineur protocol cri-
teria. The LDL susceptibility to in vitro induced lipid peroxidation was evaluated following its incuba-
tion with a FeSO4/ascorbic acid prooxidant system. Total sialic acid was determinated by Ehrlich react-
ive reaction, incubated 30 minutes at 95 oC. Results obtained showed an insignificant increase of LD-
Lox susceptibility at senescent group compared with a presenescent group (6.892.02 vs. 3.852.30
mmoli MDA/dl serum). This sugests the existance of antioxidant protection individual mecanisms of
this fraction. As for sialic acid data revealed the same increase tendency at senescent versus presenes-
cent group (69.333.45 vs. 61.903.11 mg/dl serum). Because of multiple morphological changes in
the immune system occurring with advancing age, this tendency to increase might be due both to lipid
metabolism disorders and oxidative modifications of plasma lipoproteins.
Studii privind acidul sialic i LDL oxidat n procesul de senescen

Constantin Gianina Ioana, Opri Simona
Institutul Naional de Gerontologie i Geriatrie "Ana Aslan"
Prin faptul c acidul sialic poate afecta catabolismul lipoproteinelor de joas densitate la nivel
celular, se poate presupune c acest coninut ar fi de asemenea asociat cu metabolismul LDL in vivo.
Scopul studiului de fa a fost determinarea coninutului de lipoproteine modificate oxidativ i acid sia-
lic, la un grup de pacieni presenesceni (55.945.67 ani), fa de un grup de pacieni senesceni (72.63
5.8 ani), selectai conform criteriilor protocolului Senieur. Susceptibilitatea LDL la peroxidarea lip-
idic indus in vitro a fost evaluat prin incubare, n prezena unui sistem prooxidant format din FeSO 4/
acid ascorbic. Acidul sialic total s-a determinat prin reacia cu reactivul Ehrlich, prin incubare la 95oC
timp de 30 minute. Rezultatele obinute arat o tendin de cretere a susceptibilitii LDLox n cazul
pacienilor senesceni, aceasta fiind totui nesemnificativ fa de presenesceni (6.892.02 vs.
3.852.30 mmoli MDA/dl ser). Aceasta sugereaz existena unor mecanisme individuale de protecie
antioxidant a acestei fraciuni. i n cazul acidului sialic se constat aceeai tendin de cretere ne-
semnificativ la senesceni n raport cu presenescenii (69.333.45 vs. 61.903.11 mg/dl ser). Deoarece
cu naintarea n vrst se produc multiple schimbri morfologice ale sistemului imunitar, aceast ten-
dinta de cretere s-ar putea datora att tulburrilor metabolismului lipidic, ct i modificrilor oxidative
suferite de lipoproteinele plasmatice.
P51. The status of whole blood zinc and copper levels in autistic children
Crciun Elena Cristina1, Ursu Monica2, Predescu Elena3, Bjrklund Geir4, Dronca
Maria4
1. Pharmaceutical Biochemistry and Clinical Laboratory Dept., Faculty of Pharmacy; Iuliu
Haieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2. Research
Institute for Analytical Instrumentation, Cluj Napoca, Romania; 3. Pediatric Psychiatry Dept.,
Faculty of Medicine, Iuliu Haieganu University of Medicine and Pharmacy, Cluj-Napoca,
Romania; 4. Medical Biochemistry Dept., Faculty of Medicine, Iuliu Haieganu University
of Medicine and Pharmacy, Cluj-Napoca, Romania
Autistic spectrum disorders are lifelong developmental disabilities. These disorders are presen-
ted from birth or very early in the development and affect essential human behaviors such as social in-
teraction, the ability to communicate ideas and feelings, imagination, and the establishment of relation-
ships with others. Several studies have suggested a disturbance in the copper and zinc metabolism in
autism. Copper and zinc are important for a healthy neurological function. Heavy metal detoxification
has become a widespread method of treatment for autism, and helps remove mercury and other metals
from the body. We have investigated, in the present study, the levels of zinc and copper in whole
blood, as well as the copper/zinc ratio in a group of 28 children with autism. The patient group was
compared with healthy age and sex matched control subjects. The concentrations of copper and zinc
were measured in whole blood with inductively coupled plasma-mass spectrometry. We found that
zinc level was decreased (P<0.001), and copper/zinc ratio was increased (P<0.001) in autistic children
compared with a healthy control group. Knowing that zinc upregulate the gene expression of metallo-
thionein, an important protein implicated in heavy metal detoxification and in the elimination of free
radicals throughout the body, we consider that the zinc deficiency could contribute in autism pathogen-
esis.
Statusul zincului i cuprului din sngele integral la copiii autiti

Crciun Elena Cristina1, Ursu Monica2, Predescu Elena3, Bjrklund Geir4, Dronca
Maria4
1. Catedra de Biochimie Farmaceutic i Laborator clinic, Facultatea de Farmacie,
UMFIuliu Haieganu, Cluj-Napoca, Romnia; 2. Institutul de Cercetri pentru
Instrumentaie Analitic, Cluj-Napoca, Romnia; 3. Departamentul de Psihiatrie Pediatric,
Facultatea de Medicin, UMF Iuliu Haieganu, Cluj-Napoca, Romnia; 4. Catedra de
Biochimie Medical, Facultatea de Medicin, UMFIuliu Haieganu, Cluj-Napoca,
Romnia
Autismul este o tulburare neurologic grav care survine la copii naintea mplinirii vrstei de 3
ani, caracterizat prin afectarea capacitii de comunicare i a interaciunilor sociale, precum i de com-
portamente repetitive i stereotipe. Un numr relativ redus de studii sugereaz o alterare a
metabolismului cuprului i zincului n autism. Aceste oligoelemente sunt importante pentru
funcionarea normal a sistemului nervos, precum i n eliminarea metalelor grele din organism. n
studiul de fa, am evaluat nivelul zincului i cuprului din sngele integral, precum i raportul
cupru/zinc la un grup de 28 copii autiti, comparativ cu un grup martor potrivit ca vrsta i sex.
Concentraiile celor dou oligoelemente s-au determinat prin spectrometrie de mas cu plasma cuplat
inductiv. La pacienii autiti s-a observat un nivel sczut al zincului (P<0.001) i o valoare crescut a
raportului cupru/zinc (P<0,001), fa de grupul martor. tiind c zincul stimuleaz exprimarea genei
metalotioneinei, o protein important n eliminarea radicalilor liberi i a metalelor grele din
organismul uman, apreciem c deficiena de zinc ar putea contribui la patogeneza autismului.
P52. Synovial fluid crystal analysis in arthropathies

Dumitracu V.1,2, Vlad Daliborca Cristina2, Matusz Anca Alexandra3, Poenaru D.V.4,
Gju S.2, Cinca Rodica1
1. Dept. of Pharmacology, University of Medicine and Pharmacy Victor Babe, Timioara,
Romania; 2. Laboratory Dept., Clinical Emergency Hospital, Timioara, Romania; 3. Private
Family Health Care Unit, Timioara, Romania; 4. Dept. of Orthopedy Traumatology II,
University of Medicine and Pharmacy Victor Babe, Timioara, Romania
Introduction: Calcium containing crystals can cause the degeneration of articular tissues in two
pathways: the direct pathway, crystals induce synoviocytes to proliferate and produce metallopro-
teinases and prostaglandins; the paracrine pathway involves the interaction between crystals and mac-
rophages/monocytes, which leads to the synthesis, release of cytokines and causes degeneration of ar-
ticular tissues. Methods: 17 synovial fluid (SF) samples divided in two groups were examined: first -
with chronic knee pain (n=11); second, without (n=6). In the first group, radiographic chondrocalcinos-
is, arthritis or both were observed in 2, 3 and 7 patients; in those without pain, in 1, 0, respectively 5
patients. 7 patients had previous pseudogout crises; joint inflammation occurred in 10 of 11 patients in
the first group and 4 in the second group. Joint inflammation was absent at the time of the study, pa-
tients had been off colchicine or NSAID (nonsteroidal anti-inflammatory drugs) for at least two
months.We examined undiluted samples in 1 hour after extraction. Crystal detection was done with an
ordinary microscope and identification confirmed with a polarized light microscope. Results: All 17
SF samples contained calcium pyrophosphate dehydrate (CPPD) crystals. CPPD crystals were ob-
served in samples from patients with previous inflammatory episodes and patients without arthritis.
Conclusion: The presence of CPPD crystals in the joint cavity suggests their slow clearance from the
cavity, or constant shedding from joint deposits, mainly in the cartilage or both. The presence of intra-
cellular crystals confirms an interaction between crystals and cells in such joints.
Analiza cristalelor din lichid sinovial n artropatii

Dumitracu V.1,2, Vlad Daliborca Cristina2, Matusz Anca Alexandra3, Poenaru D.V.4,
1. Catedra de Farmacologie, UMFVictor Babe, Timioara, Romnia; 2. Laborator Clinic,
Spitalul Clinic Judeean de Urgen, Timioara, Romnia; 3. Cabinet Privat de Medicina
Familiei, Timioara, Romnia; 4. Clinica de Ortopedie Traumatologie II, UMFVictor
Babe, Timioara, Romnia
Introducere: Cristalele care conin calciu pot cauza degenerarea esutului articular prin dou
ci: calea direct (cristalele induc proliferarea sinoviocitelor i producerea de metaloproteinaze i
prostaglandine); calea paracrin (implic interaciunea ntre macrofage/monocite ducnd la sinteza i
eliberarea citokinelor i cauznd degenerarea esutului articular). Metode: S-au examinat 17 probe de
lichid sinovial (LS), mprite n dou grupuri: primul grup cu durere articular cronic (n=11); al
doilea grup fr durere (n=6). La nivelul primului grup condrocalcinoza, artrita sau amndou au fost
observate radiografic la 2, 3 i 7 pacieni; iar la cei fr durere la 1, 0 respectiv 5 pacieni. 7 dintre
pacieni au prezentat crize de pseudogut anterior studiului; inflamaia articulaiei genunchiului s-a
observat la 10 din 11 pacieni aparinnd primului grup respectiv 4 din al doilea grup. Inflamaia
articular a fost absent pe durata studiului, pacienii ntrerupnd tratamentul cu colchicin sau AINS
(antiinflamatoare nesteroidiene) cu cel puin dou luni nainte de nceperea acestuia. Probele nediluate
au fost examinate ntr-o or de la recoltare. Detectarea cristalelor a fost efectuat cu ajutorul unui
microscop normal i confirmat cu ajutorul luminii polarizate. Rezultate: Toate cele 17 probe de LS
au coninut cristale de cristale de calciu pirofosfat dihidrat (CPPD). Acestea au fost observate att n
probele pacienilor care au prezentat episoade inflamatorii anterioare ct i la cei fr artrit.
Concluzii: Prezena cristalelor de CPPD n cavitatea articular sugereaz fie clearance-ul lor ncetinit
din articulaie fie difuziunea lor din depozitele articulare n special n cartilaj sau amndou. Prezena
cristalelor intracelular confirm o interaciune ntre cristale i celulele acestor articulaii.
P53. Infrared spectroscopy of synovial fluid in patients with gonarthrosis

analytical approaches and clinical challenges
Vlad Daliborca Cristina1, Dumitracu V.1,2, Matusz Anca Alexandra3, Poenaru D.V.4,
Cinca Rodica2
1. Laboratory Dept, Clinical Emergency Hospital, Timioara, Romnia; 2. Dept. of
Pharmacology, University of Medicine and Pharmacy Victor Babe, Timioara, Romnia;
3. Private Family Health Care Unit, Timioara, Romnia; 4. Dept. of Orthopedy
Traumatology II, University of Medicine and Pharmacy Victor Babe, Timioara, Romnia
Background: Infrared spectroscopy (IR) is a widely used analytical method which provides the
basis for accurate identification of numerous components in biofluids. The purpose of the present study
was to carry out an investigation based upon the obtained IR spectra of synovial fluid. Methods: 11
synovial fluid samples were aspirated from arthrosic knee joints for the study (study group) and com-
pared with 11 infrared spectra obtained from non-arthrosic synovial fluid (control group). Spectra were
measured on a JASCO FT/IR spectrophotometer, with automatic listing of absorption bands, in the
range 600-4000 cm-1. Results: The IR spectra from both groups were dominated by absorption bands
that correspond to proteins, lipids and carbohydrates. In patients with gonarthrosis (GA), the spectral
range 1230-1260 cm-1 is dominated by absorptions arising from C-O stretching vibrations of hyaluronic
acid. Differences in this spectral region may be attributed to degradation of hyaluronic acid during the
arthrosic process which leads to a reduced viscosity and lubricating properties of synovial fluid and in-
creased friction within the joint. In obese patients with GA, the lipid absorption band at 1640 cm-1 is
directly correlated with hypercholesterolemia detected in serum and synovial fluid. Conclusion: In-
frared spectroscopy reveals important differences between spectra obtained from normal and arthrosic
synovial fluid samples. They are related to variations in the concentration of macromolecules within
the joint caused by alterations in joint physiology occured in gonarthrosic patients. Keywords: infrared
spectroscopy, synovial fluid, gonarthrosis.
Spectroscopia n infrarou a lichidului sinovial la pacienii cu gonartroz

abordare analitic i preocupare clinic
Cinca Rodica2
1. Laborator Clinic, Spitalul Clinic Judeean de Urgen, Timioara, Romnia; 2. Catedra de
Farmacologie, UMFVictor Babe, Timioara, Romnia; 3. Cabinet Privat de Medicina
Introducere: Spectroscopia n infrarou (IR) constituie o metod analitic larg utilizat, care
asigur baza identificrii precise a numeroi compui existeni n biofluide. Scopul prezentului studiu
este efectuarea unei investigaii bazate pe spectrele IR obinute din lichidul sinovial. Metode: 11 probe
de lichid sinovial au fost aspirate din articulaiile genunchilor cu artroz n scopul studiului (grupul de
studiu) i comparate cu 11 spectre n infrarou obinute din lichid sinovial ne-artrozic (grupul de
control). Spectrele au fost trasate cu un spectrofotometetru JASCO FT/IR, cu citire automat a ben-
zilor de absorbie, n domeniul 600-4000 cm-1. Rezultate: Spectrele IR la ambele grupuri au fost
dominate de benzi de absorbie corespunztoare proteinelor, lipidelor i carbohidrailor. La pacienii cu

gonartroz (GA), domeniul spectral 1230-1260 cm-1 este dominat de absorbia rezultat din vibraia de
valen a gruprii C-O a acidului hialuronic. Diferenele remarcate n aceast regiune spectral pot fi
atribuite degradrii acidului hialuronic pe parcursul procesului artrozic, care duce la reducerea vsco-
zitii i proprietilor lubrifiante ale lichidul sinovial i determin intensificarea friciunii articulare. La
pacienii obezi cu GA, banda de absorbie a lipidelor situat la 1640 cm -1 a fost direct corelat cu hiper-
colesterolemia seric i cea din lichidul sinovial. Concluzii: Spectroscopia n infrarou evideniaz
deosebiri importante ntre spectrele obinute din probele de lichid sinovial normal i cel artrozic.
Aceste diferene sunt datorate variaiilor de concentraie a macromoleculelor n interiorul articulaiei,
cauzate de modificrile fiziologiei articulare survenite n gonartroz. Cuvinte cheie: spectroscopie n
infrarou, lichid sinovial, gonartroz.
P54. Usefulness of synovial fluid analysis in the evaluation of arthritis

Gju S.1, Cinca Rodica 2
1. Laboratory Dept., Clinical Emergency Hospital, , Timioara, Romnia; 2. Dept. of
Pharmacology, University of Medicine and Pharmacy Victor Babe, Timioara, Romnia;
3. Private Family Health Care Unit, Timioara, Romnia; 4. Dept. of Orthopedy
Traumatology II, University of Medicine and Pharmacy Victor Babe, Timioara, Romnia
Introduction: Synovial fluid (SF) analysis is important in evaluation of patients with arthritis. It
can help determine whether the fluid is inflammatory or non-inflammatory and the type of arthritis.
Methods: From 39 patients, 34 SF were suitable for the study: 3 samples were contamined with blood,
and no fluid was obtained in other 2 patients. We divided 2 groups according to the presence of pain:
pain group (n=22) and asymptomatic group (n=12). Analysis was performed within one hour of joint
aspiration. The cell count in SF was done manually from undiluted samples using a haemocytometric
chamber. Results: From the 34 patients studied 23 were women and 11 men (mean age = 65.712.8).
The mean cell count was 300.317.5 cells/l (84.8% mononuclear cells, 15.2% PMN). 24% of cells
contained crystals (most of these mononuclear cells, some PMN also showed intracellular crystals, of-
ten more than one crystal). The mean proportion of cells with intacellular crystals was 24.1% in the
pain group and 25.1% in the asymptomatic group. The mean cell count in the pain group was
341.520.2 cells/l and 209.112.4 cells/l in the asymptomatic group; PMN cells accounted for a
mean of 21.5% of cells in the pain group and for 14.5% in the asymptomatic group. Conclusion: The
presence of inflammation is supported by the higher than normal cell count and by the presence of
PMN cells. Cell counts and the percentage of PMN cells provide relevant information about the degree
of joint inflammation. Key words: synovial fluid; arthritis.
Utilitatea analizei lichidului sinovial n evaluarea artritei

1. Laborator Clinic, Spitalul Clinic Judeean de Urgen, , Timioara, Romnia; 2. Catedra
de Farmacologie, UMFVictor Babe, Timioara, Romnia; 3. Cabinet Privat de Medicina
Introducere: Analiza lichidului sinovial (LS) este important n evaluarea pacienilor cu artrite;
aceasta poate confirma natura lichidului, inflamatorie sau noninflamatorie, i de asemenea, tipul
artritei. Metode: Din 39 de pacieni luai n studiu, doar 34 de probe de LS au fost conforme pentru
continuarea studiului; 3 dintre probe au fost contaminate cu snge, iar 2 dintre pacieni nu au prezentat
lichid intraarticular. Dup prezena sau absena durerii articulare, pacienii au fost mprii n dou
grupuri: grupul care a prezentat durere (n=22) i grupul asimptomatic (n=12). Analiza LS a fost efec-
tuat n decurs de o or de la recoltare. Numrtoarea celulelor din LS a fost efectuat manual, din
probe nediluate, utilizndu-se o camer hemocitometric Fucks Rosenthal. Rezultate: Din cei 34
pacieni studiai, 23 au fost femei i 11 brbai (cu vrsta medie = 65.712.8 ani). Media celulelor
numrate a fost de 300.317.5 celule/l (84.8% fiind mononucleare i 15.2% polimorfonucleare). 24%
au coninut cristale intracelular, dintre acestea cele mai multe fiind mononucleare, dar i PMN
(polimorfonucleare), coninnd adesea chiar mai mult de un cristal. Media proporiei celulelor cu
cristale intracelulare a fost de 24.1 % la grupul de pacieni care prezenta durere i 25.1% la grupul
asimptomatic. Media celulelor numrate la grupul cu durere a fost de 341.520.2 celule/l i
209.112.4 celule/l la grupul asimptomatic. Concluzii: Inflamaia articular este susinut de numrul
mai mare dect normal de celule prezente n LS i de prezena PMN. Numrul celulelor i procentul
PMN furnizeaz informaii relevante i despre gradul inflamaiei articulare. Cuvinte cheie: lichid
sinovial, artrit.
P55. Nephrological syndromes nephritic and nephrotic sediments

Gju S.1, Flangea Corina 2, Dumitracu V. 1,3, Vlad Daliborca 1,3, Petrica Ligia 4
1. Central Laboratory of the County Emergency Hospital,Timioara,; 2. Dept. of
Biochemistry, Victor Babe University of Medicine and Pharmacy, Timioara; 3. Dept. of
Pharmacology Victor Babe University of Medicine and Pharmacy, Timioara; 4. Dept. of
Nephrology Victor Babe University of Medicine and Pharmacy, Timioara
Urinary analysis is a useful tool for identification and discrimination nephritic versus nephrotic
syndrome. Nephritic syndrome is associated with glomerular disorders which permit proteins and red
blood cells to pass into the urine. By contrast, nephrotic syndrome is characterized by only proteins
moving into the urine. The main goal of our study was to demonstrate the importance of the urinary
sediment aspect in those two disorders and interpretation of laboratory data by clinician. For this pur-
pose, we investigate urinary sediment of 54 cases admitted in Nephrology Department with a kidney
disease diagnostic that led to nephritic or nephrotic syndrome. We used parallelism of the microscopic
techniques (bright field, phase contrast and polarized light) and also the observation of the sediment
elements in both unstained and stained samples (May-Grnwald-Giemsa, Sudan III and Sternheimer-
Malbin stain). The nephritic sediments (n=33) illustrated dismorphic red blood cells, sometimes ac-
companied by red blood cells casts. Also many granular and cellular casts can be observed. White
blood cells were occasionally seen but their number was lower than the number of erythrocytes. The
nephrotic sediments (n=11) revealed a mass of granular casts beside hyaline casts, oval fat bodies and
fatty casts. Few cholesterol crystals could be seen. Abundant hematuria and red blood cells casts were
identified in two nephrotic cases suffering by glomerular disorder with proteinuria higher than 4 grams/
day. We can conclude that urinary sediment analysis has an important contribution to discrimination
between nephritic and nephrotic syndrome and give us essential information about kidney damage.
Sindroamele nefrologice sedimente nefritice i nefrotice

Gju S.1, Flangea Corina 2, Dumitracu V. 1,3, Vlad Daliborca 1,3, Petrica Ligia 4
1. Laboratorul Central de Analize, Spitalul Clinic Judeean de Urgen Timioara,; 2.
Disciplina de Biochimie, UMF Victor Babe, Timioara; 3. Disciplina de Farmacologie,
UMF Victor Babe, Timioara; 4. Disciplina de Nefrologie, UMF Victor Babe,
Timioara
Examenul de urin este un element esenial n identificarea i diferenierea sindromului nefritic
de sindromul nefrotic. Sindromul nefritic este asociat cu afeciunile glomerulare care permit trecerea
proteinelor i hematiilor n urin. n contrast, sindromul nefrotic se caracterizeaz doar prin trecerea
proteinelor n urin. Principalul scop al studiului nostru este demonstrarea importanei aspectului sedi-
mentului urinar n aceste dou afeciuni i interpretrii datelor de laborator de ctre medicul clinician.
Pentru aceasta, am analizat sedimentul urinar provenit de la 54 de pacieni internai n Clinica de Ne-
frologie, diagnosticai cu o afeciune renal ce determin apariia sindromului nefrotic sau nefritic. Am
utilizat paralelismul tehnicilor microscopice (microscopie n cmp luminos, contrast de faz i lumin
polarizat) precum i colorarea preparatelor microscopice acolo unde a fost necesar utiliznd coloraiile
May-Grnwald-Giemsa, Sudan III i Sternheimer-Malbin. Sedimentele nefritice (n=33) au ilustrat
prezena hematiilor dismorfe uneori acompaniate de cilindri eritrocitari. De asemenea, au putut fi ob-
servai numeroi cilindri celulari i granuloi. Leucocitele au fost prezente doar ocazional dar ntot-
deauna numrul lor a fost mai mic comparativ cu cel al hematiilor. Sedimentele nefrotice (n=11) evid-
eniaz o mas de cilindri granuloi alturi de cilindri hialini, corpi grsoi ovali i cilindri grsoi.
Cteva cristale de colesterol au fost de asemenea prezente. O hematurie abundent nsoit de cilindri
eritrocitari a fost identificat n dou cazuri de sindrom nefrotic cu afectare glomerular i proteinurie
de peste 4 grame/24 ore. Astfel, putem concluziona c analiza sedimentului urinar are o contribuie im-
portant la diferenierea sindromului nefritic de sindromul nefrotic i ofer informaii eseniale asupra
afectrii renale.
P56. Diselectrolytemia risk factor for atrial fibrilation after aortic valve
replacement
Velimirovici Dana, Rada Maria, Berceanu Vduva Delia, Drgan Simona, Berceanu
Vduva M., Duda Seiman D.M., Cobzariu I.F., Rdlescu Matilda, Arambaa Alexandra,
Manca Silvia
Victor Babe University of Medicine and Pharmacy, Timioara
Objectives: The influence of diselectrolytemia, along with other pre-, intra-, and postoperative
factors, on the occurrence of rythm disorder, especially atrial fibrilation (AF) after aortic valve replace-
ment with mechanical or biological valve prosthesis. Material and method: the study included 45 pa-
tients (27 men and 18 women) with aortic prosthesis from the Cardiovascular Rehabilitation Clinic
Timioara, in average 8,5 days after aortic valve replacement. All patients were electrocardiographic-
ally monitored (EKG and Holter rythm/24 hours) during hospital admittance, and one month postoper-
ative. The threshold values for defining diselectrolytemia were: hypokalemia < 3,5 mEq/l and
hypomagnesemia < 1,6 mg%. Results: Atrial fibrilation was the most frequent arythmia after heart sur-
gery, its occurrence being of 44,44% in the study; 6,66% of the patients showed preoperative AF, and
in 37,77% of the patients, AF occurred as a postoperative complication. A month after surgery, its oc-
currence seriously diminishes from 44,44% to 11,11% (p<0,001). Diselectrolytemia occurrence in the
beginning of the study was 40%, and one month after surgery it seriously diminished to 15,55%
(p<0,001). Hypokalemia was the most frequent diselectrolytemia, occurring in both precocious preop-
erative stage and after a month (17,77% vs. 8,88%). 33,33% of the dislectrolytemia patients showed
AF at the moment of study inclusion, compared with 11,11% one month after surgery. Conclusions:
Diselectrolytemia, frequently occurring after surgery, is a triggering factor for rythm disorders. Hypo-
kalemia occurrence was much higher among AF patients. A month after surgery, AF occurrence seri-
ously diminished through correction of diselectrolytemia and other factors.
Diselectrolitemia factor de risc al apariiei fibrilaiei atriale post-nlocuire

valvular aortic
Velimirovici Dana, Rada Maria, Berceanu Vduva Delia, Drgan Simona, Berceanu
Vduva M., Duda Seiman D.M., Cobzariu I.F., Rdlescu Matilda, Arambaa Alexandra,
Manca Silvia
UMFVictor Babe, Timioara
Scopul lucrrii: S-a urmrit influena diselectrolitemiilor alturi de ceilali factori pre-, intra- i
postoperatori asupra incidenei tulburrilor de ritm, n special a fibrilaiei atriale (FA), post-nlocuire
valvular aortic cu protez mecanic sau biologic. Material i metod: Au fost inclui n studiu 45
pacieni (27 brbai, 18 femei) protezai aortic internai n medie la 8,5 zile postoperator n Clinica de
Recuperare Cardiovascular Timioara. Toi pacienii au fost monitorizai electrocardiografic (ECG i
Holter ritm/24 ore) pe perioada internrii i la o lun postoperator. Valorile prag pentru definirea dise-
lectrolitemiilor au fost: hipopotasemie <3,5mEq/l i hipomagnezemie <1,6mg%. Rezultate: Fibrilaia
atrial a fost cea mai frecvent aritmie dup chirurgia cardiac, incidena sa fiind de 44,44% la inclu-
dere n studiu; 6,66% din pacieni au prezentat FA i preoperator, iar la 37,77% aceasta a survenit ca o
complicaie postoperatorie. La o lun postoperator incidena acesteia se reduce semnificativ de la
44,44% la 11,11% (p<0,001). Incidena diselectrolitemiilor la debutul studiului a fost de 40%, iar la o
lun postoperator aceasta a sczut semnificativ la 15,55% (p<0,001). Hipopotasemia a fost cea mai
frecvent diselectrolitemie ntlnit att n faza postoperatorie precoce ct i la o lun (17,77% versus
8,88%). Un procent de 33,33% din pacienii cu diselectrolitemie au prezentat FA la includere n studiu,
comparativ cu 11,11% la o lun postoperator. Concluzii: Diselectrolitemiile, frecvent ntlnite posto-
perator, constituie un factor precipitant al tulburrilor de ritm. Incidena hipopotasemiei a fost mult mai
crescut n rndul pacienilor cu FA. La o lun postoperator incidena FA s-a redus semnificativ att
prin corecia diselectrolitemiei ct i a celorlali factori implicai n apariia acesteia.
Authors index
Index de autori
A Bashkatov S.V.: C26

Beaulieu Yves: R58
Admu Marcela: P7, P8, P13, P16, Belengeanu V.: C20
P17, P18 Bene Liliana: R3
Al-Aissa Zahra: C59 Benedek Erzsbet: C9
Albu Elena: P49 Benedek I.: C9
Albu Irina: P49 Berceanu Vduva Delia: P16, P2, P7,
Amzar Daniela: P33 P8, P10, P13, P14, P17, P18, P19,
Anghel Andrei: P44 P56
Anghel G.: C45 Berceanu Vduva M.: P2, P10, P56
Anisiei Ecaterina: P40 Bereczky Z: R31, R32, P27
Antmann Katalin: P1 Bilc Doina Veronica: C44, C41, C43
Anton G.: C20 Bjrklund Geir: P51
Anton Gabriela: P34, P35 Blaton V.: R53
Apati Estera: P3, P15 Bonte Diana Camelia: P28, P44, P45
Arambaa Alexandra: P10, P56 Bonte Ovidiu Horia: P45
Borza Claudia: P46, P47
Botea S.: P12
B Braha Elena: C22
Brnzeu Cristina: P20
Babayan A.Y.: C26
Bricca Giampiero: R51
Babiuc Constantin: P21
Brudac Ioana : R33
Bacrea Anca: C16
Bujoran Cornel: C22
Bacrea Vladimir: C16
Bumbcila Bogdan: P34
Badicut I.: P12
Burt Olivia Ligia: P30
Bdioiu Luminia: P7, P20
Butil Todoran Anamaria: C9, C24,
Badiu C.: C20
C27
Bagoly Z: R31
Butnariu Lcrmioara: C22
Blceanu Alina: P8
Balogh-Smrghian V.: P6, C61
Bncescu A.: C36 C
Bnescu Claudia: C9, C24, C27, C28
Bnfi Renta: P1 Caba Lavinia: C22
Barbarii L.: C66, P26 Carasevici Eugen: R65
Barna Zsfia: P1 Chicin Graiana: P20
Chiriac Carmen: C48, P5 Dorobat Olga Mihaela: P12

Ciacli Camelia: P22, P31, P32, P41, Drgan Ana-Maria: P11
P42, P43 Dragan Petru: C63
Cinca Rodica: P52, P53, P54 Drgan Simona: P10, P56
Cobzariu I.F.: P10, P56 Dragomirescu Liliana: P13, P19, P20
Codi Irina: R38 Dronca Maria: C60, P51
Colhon D.M. : R33 Drugan Cristina: C24, C25
Constantin Gianina: P48, P50 Duda Seiman D.M.: P56
Constantin Nicoleta: P25 Dugeescu Dorina: P2, P14, P18
Constantinescu A.: C66, P26 Duicu Carmen: C9
Constantinescu C.: C66, P26 Duicu Oana: P46, P47
Cornianu Marioara: P33, P36 Dumache Raluca: P34, P35
Costi Simona: P33, P36 Dumitracu V.: P52, P53, P54, P55
Covic Mircea: C22, C29 Du-Cornescu Georgiana: P25
Crciun Elena Cristina: C60, P51, C61
Crciunescu Mihaela: P7, P8, P14, P16,
E
P17, P19
Crasnic Ioan: P22
Elefterescu Mrioara: P9
Crisan Tania: C23
Erdelean V.: P41, P42
Cristea Anca: R3
Cristescu Carmen: P46, P47
Csp Katalin: C27, C28, C9, C24 F
Cuciureanu Rodica: P49
Cucu N.: C20 Fa Ingrid: P24
Cucu Natalia: P34 Farcas M.: C23
Cucuianu Andrei: C8, C10, R15, C16 Farkas Lszlo Attila: C43
Cucuianu Mircea: R33 Faur Alexandra: P33, P36
Czdula Andrs: C61 Fazakas Zita: P6, P29
Filip Cristiana: P49
Filip Florina: P40
D Filipas Cristina: R15
Fischer G.F.: P24
Dan D.: C20
Flangea Corina : P55
Dancescu M.: C62
Fodor Andrea: P5
David Dana Liana: P44, P45
Fodor Mrta Andrea: C48
David G.: C62
Foia Liliana: P40
Dema Alis: P36
Fldes Annamria: C41, C43
Dican Lucia: P24
Foris Vasile : C68
Diculescu M.: C66
Funduc Ileana: R64
Dima Delia: C8, C10
Dimitriu Cristina: P40
Dobre Michaela: P25 G
Dobreanu Dan: P37
Dobreanu Minodora: C48, R54, C59, Gacs Mria: C40
C61, P5 Giculescu M.: P26
Dorcioman Bogdana: C16 Ginaru Cecilia: P48
Garbovan Cristina: C48 J

Georgescu Anca: C48
Gheoca Roxana: P38, P39 Jk Zsuzsanna: C61
Gherase C.: C45
Ghete Mihaela: P46, P47
Gju S.: P52, P54, P55
K
Grbea G.: P26, C66
Karyakin O.B.: C26
Gliga Camelia: C27
Kastal Timea: P6
Gligor Ramona: P22, P43
Kaycsa Adriana: P35
Golieanu Madalina: P31, P32
Kezdi Iringo: C48
Gologan S.: C66
Kirizs Rbert: C59
Golu Ioana: P33
Ksa Beta: C61
Gorduza Eusebiu Vlad: C22
Kovcs E: R32
Gorduza Vlad: C29
Kovcs EG: P27
Gotia Laura: P31, P32, P41, P42
Gotia Smaranda: P31, P32, P41, P42
Grmescu Mihaela: C22 L
Grigorescu-Sido Paula: C25
Gurban Camelia: P22, P31, P32, P41, Lszl Annamria: P29
P42, P43 Lazr Elena: P36
Gurban Camelia Vidia: P36 Lazslo Anamaria: C27
Lazureanu Codruta: P33, P36
Licker Monica: P7, P8, P13, P14, P16,
H P17, P18, P19, P20
Lighezan Daniel Florin: P28
Hajbel-Vkony Gabriella: C40
Lighezan Rodica: P28, P44, P45
Haramura G: P27
Liszt Ferenc: R2
Higgins Trefor: R57, C59
Lrinczi Lilla: C41
Hobai tefan: R4
Lung Valentin: C68
Hogea Elena: P14, P16, P18, P20
Horhat F.: P14, P19, P20
M
I Man A.: C42, C44
Manca Silvia: P10, P56
Iancu C.B.: C66, P26
Mare Anca: C42, C44
Iancu D.: C66, P23, P26
Marin Carmen: P9
Incze Andrea: C48
Marusca Patricia: P15
Ionescu D.: C36
Mateescu Rodica: P46
Ionescu G.: R35, C36, C39
Matusz Anca Alexandra: P52, P53, P54
Ionescu I.: C62
Micle Otilia: C60, P3, P15
Ionescu Iulian: C63
Mihala Adrian: P31, P32
Ioni Hortensia: C11
Militaru M.: C21
Ioni Ioana: C11
Militaru Mariela: C21, C23
Ivanov Iuliu: C22, C29
Militaru Mariela S.: C10
Moldovan Andreea: C48
Moldovan Roxana: P2, P7, P8, P13, P29

P14, P16, P17, P18, P19, P20 Pszti Judit: C40, P1
Mortan Ramona: P3, P15 Patiu Mariana: C10, R15, C16
Mo Ioana: P11, P30 Punescu Iulieta: P28
Motoc Marilena: P45 Pelea Diana: P4, P30
Muntean Delia: P2, P7, P8, P13, P14, Perian Marcel: P37
P16, P17, P18, P19, P20 Petrica Ligia: P55
Muset Gheorghe: P21 Petrov Ljubomir: C8, C10
Muszbek L: R31, P27 Piciu Doina: C68
Muszbek L. : R32 Pilu C.: P14, P19
Pilu Ciprian: P13
Pintilie G. Sofia: C62, C63
N
Prvan Ramona: P2, P13, P18
Poenaru D.V.: P52, P53, P54
Nadig Satish: R55
Poenaru Mrioara: P7
Ncuiu Alexandra - Maria: C37
Popa Daniela: P3, P4, P15
Nastase Violeta: R15
Popa Mihaela: P2, P7, P13, P14, P16,
Neagu E.: C66, P26
P18
Negrean Rodica: P15
Popescu Roxana: C22
Negur Lucian: C29
Popoiu M.: P12
Negut M.: R35, C39
Popp R.A.: C21, C23
Nemes-Nagy Enik: C59, C61
Popp Radu A.: C10
Nmeth Melinda: P1
Predescu Elena: P51
Nemtsova M.V.: C26
Puiu Maria: C19, C20, P34, P35
Neuman Manuela: R47
Puschita Maria: P22, P31, P32, P41,
Nicola Doina: P28
P42
Nicolescu .: C45
Pusks A: R31
Nistor Elena: P28
Noveanu Lavinia: P47
R
O
Rada Maria: P10, P17, P56
Rdlescu Matilda: P56
Olariu Rare: P28
Rducan Andreea: P47
Oltean Galafteon: C16
Radulescu Ariadna: C67
Olteanu C.: P9
Rdulescu Matilda: P2, P7, P8, P10,
Oprea Malina: C62
P13, P16, P19
Oprea Mihaela: C43
Rafila A.: R35, C39, P12
Opri Simona: P48, P50
Rahaian Rodica: R3
Russu Eugeniu: P21
P Rusu Cristina: C22, C29
Pall Emke : C68

Panaitescu Carmen: P8 S
Pnzariu Monica: C22
Sabu Monica: C48
Pacanu Ionela: C9, C24, C27, C28,
Saizu Ana Magdalena: P38, P39
Sali Vera: P21 Trandafir C.: C66

Snta Dra: C61 Trifa A.: C21
Savescu Iasmina: P41, P42 Trifa A.P.: C23
Savoiu Germaine: P46, P47 Trifa Adrian P.: C10
chiopu A.: P29 ucra R.: C45
Schiopu Alexandru: R55
Scridon Alina: P37
U
Selicean Cristina: R15
erban C.: P35
Ungureanu Didona: P40
erban Corina: P46, P47
Ungvri Erika: C40
erban D.: P16, P17, P19
Urcan Rodica: C48
Serban Rzvan C.: P37
Ursu Monica: P51
Sfrijan Felicia: P31, P32, P41, P42
Simona Drgan: P17
Simon-Grui Alexandra: P25 V
Sitariu Anca: P43
Soriu Olga : C68 Valuch Anton: P48
Stamatian F.: C21 Vargha Mrta: P1
Stng Livia: P2 Velimirovici Dana: P2, P10, P17, P56
Stanoiev J.: P8, P20 Venczellk M: P27
Stoian M.: C20 Vlceanu Ioana: P23
Stoian Monica: C19 Vitan A.: C45
Stoian Veronica: P25 Vlad Daliborca : P55
Stoica Ortansa: C22 Vlad Daliborca Cristina: P52, P53, P54
Stru Monica: C43 Voidzean Septimiu: C41
Szekely Edit: C42, C44, C41, C43 Volociuc Mihail: C22, C29
T W
Tbrc N.: C45 Wood Kathryn J.: R55

Talapan D.: P12
Talpes V.: C66, P26 Z
Teaha Monica: P3, P4, P30
Tenea C.: P12 Zaharia-Kzdi Iring: P6
Teplov A.A.: C26 Zaharie Daniela: C63
ilea Brindua: C48, P5 Zaletaev D.V.: C26
Todor Mihaela: P9 Zamoteanu Nina: P49
Todoran-Butil Anamaria: C28 Zdrnc Mihaela: P11, P30
Toma Felicia: C42, C44 Zlei Mihaela: P40
Toma Vasilica: P40 Zld Gizella: C61
Tomuleasa Ciprian: C68 Zosin Ioana: P33, P44, P45
Tth kos: C40 Zugravu Roxana: P18
Tth E: P27
Information and Guidelines for Authors

Version: December 15th 2008.
Revista Romn de Medicin de as therapy evaluation and patient health status.

Laborator (The Romanian Review of Laborat- The Review also includes a Course Notes sec-
ory Medicine) publishes editorials, original sci- tion for medical residents and for those who
entific and professional articles general re- would like to update their knowledge into the
views, case presentations, guidelines and re- approached fields. The frequency of the Review
commendations of national and international is currently four issues per year.
scientific and professional associations, book
reviews and announces events (congresses,
Manuscript submission
symposia, courses) in the field of laboratory
medicine. Its aim is to publish new information
Manuscripts and all attached files
which can lead to a better understanding of the
(tables and illustrations) should be submitted in
biological mechanisms of human diseases, im-
electronic form, either using the on-line
prove prophylaxis and early diagnosis, as well
manuscript submission form available on the
Manuscript (3 copies) + CD
Receivement + technical analysis Rejection

Request for (does not respect rules)
revision (SECRETARIAT)
Acceptance (registration)
Analysis by the redaction college Rejection

(not interesting,
scientifically incorrect)
Sending the article to the referees (without revealing authors
names and degrees)
Minor faults Acceptance referral Rejection referral
Redaction college
Publication
website of the Romanian Review of Laboratory quested signed documents by regular mail to
Medicine (www.rrml.ro), or by regular mail to the Secretariat in attention to Prof. Minodora
the Editor-in-Chief, on compact disk. It is pre- Dobreanu (Editor-in-Chief), University of
ferrable that three copies of the manuscript (in- Medicine and Pharmacy, Tirgu Mures, code
cluding tables and figures), printed on one side 540136, No. 38, Str. Gheorghe Marinescu, Ro-
of A4 paper format, double-spaced, with 2.5 cm mania.
margins, be also submitted to the same address. Scanned copies sent electronically and
fax submissions are not acceptable.
Submission documents
Authorship
At the time of submission, the Romani- All named authors should meet the cri-
an Review of Laboratory Medicine requires an teria for authorship as stated in the Uniform
explicit statement by the corresponding author Requirements for Manuscripts Submitted to
warranting that the manuscript, as submitted, Biomedical Journals: Writing and Editing for
has been reviewed by and approved by all Biomedical Publication issued by the Interna-
named authors; that the corresponding author is tional Committee of Medical Journal Editors
empowered by all of the authors to act on their (www.icmje.org):
behalf with respect to the submission of the Authorship credit should be based on
manuscript; that the article does not infringe 1) substantial contributions to conception and
upon any copyright or other proprietary right of design, acquisition of data, or analysis and in-
any third party; that neither the text nor the data terpretation of data; 2) drafting the article or re-
have been published previously (abstracts ex- vising it critically for important intellectual
cepted); and that the article or a substantially content; and 3) final approval of the version to
similar article is not under consideration by an- be published. Authors should meet conditions
other journal at that time. 1, 2, and 3. [...]
Upon submission of the manuscript, the Acquisition of funding, collection of
corresponding author must provide the Editorial data, or general supervision of the research
Board with documents proving that all those group alone does not constitute authorship.
quoted for personal communications or listed in All persons designated as authors
the Acknowledgement section have agreed to should qualify for authorship, and all those who
their inclusion. Authors are responsible for ob- qualify should be listed.
taining permission to reproduce copyrighted The Romanian Review of Laboratory
material from other sources and send an authen- Medicine considers all authors to be responsible
ticated copy of the permission to the Editorial for the content of the entire paper.
Board. Authors are requested to describe their
Each author must provide a clear state- individual contributions to a study/ paper in a
ment on potential conflicts of interest in section that will be signed, attached to and sent
which he or she may be involved. The state- together with the Authorship Responsibilities
ment should include sources of funding, includ- form.
ing internal support or grants from non-com- Individuals who supplied reagents,
mercial institutions. The absence of funding strains or facilities should not be listed as au-
should also be declared. The statement on con- thors, but may be recognized in the Acknow-
flicts of interest will be published at the end of ledgements section. Individuals who gave ad-
the paper. vice on the manuscript should be acknow-
Mailing address. Please submit all re- ledged, but are not considered authors.
Research involving human subjects Corrections

or experimental animals
Scientific fraud are rare events;
If the scientific project involves human however, they have a very serious impact on the
subjects or experimental animals, authors must integrity of the scientific community. If the Ed-
state in the manuscript that the protocol has itorial Board uncovers possible evidence of
been approved by the Ethics Committee of the such problems it will first contact the corres-
institution within which the research work was ponding author in complete confidence, to al-
undertaken. Experiments on live vertebrates or low adequate clarification of the situation. If the
higher invertebrates must be demonstrated to be results of such interactions are not satisfactory,
ethically acceptable and in accordance with in- the Board will contact the appropriate
stitutional and national guidelines or regulations official(s) in the institution(s) from which the
for laboratory animals. If the manuscript reports manuscript originated. It is then left to the insti-
medical research involving human subjects, au- tution(s) in question to pursue the matter appro-
thors must include a statement confirming that priately. Depending on the circumstances, the
informed consent was obtained from all sub- Romanian Review of Laboratory Medicine may
jects, according to the World Medical Associ- also opt to publish errata, corrigenda, or retrac-
ation Declaration of Helsinki, revised in 2000, tions.
Edinburgh.
Manuscript preparation
Editorial process and peer review
Manuscripts must be written in English
Submitted manuscripts are screened for and prepared in conformity to the Uniform Re-
completeness and quality of files and will not quirements for Manuscripts Submitted to Bio-
enter the review process until all files are satis- medical Journals: Writing and Editing for Bio-
factory. The Secretariat will announce the cor- medical Publication issued by the International
responding author about the receipt and the Committee of Medical Journal Editors
status of the manuscript. (www.icmje.org).
The articles are sent to referees with ex- Authors should consult someone profi-
pertise in the laboratory medicine area, without cient in the English language, if they feel it is
revealing the authors names and position. necessary. If the manuscript is not conform to
Also, the referees identities are not known by accepted standards of English usage, the au-
the authors. Following the referees recom- thors will be required to bear the cost of English
mendations, the Editors decide if a paper is supervision/ translation: the charge is 12,5 RON
published or not. (3,5 EUR)/ supervised page and 25 RON (7
Submissions may be declined without EUR)/ translated page.
external review as deemed appropriate by the Articles must be written in Microsoft
Editor-in-Chief and the members of the Editori- Word, Style: Normal + Justified, Font: Times
al Board. New Roman, font size 12. All manuscripts must
The authors of the manuscripts that be typed double-spaced. Original source files,
have been rejected or need revision will be an- not PDF files, are required. In text editing, au-
nounced. Revised manuscripts should be resub- thors should not use spacing with spacebar, tab
mitted as soon as possible, but not later than 6 or paragraph mark, but use the indentation and
weeks. Although unusual, a resubmission may spacing options in Format Paragraph. Auto-
be rejected after revision if the response to sug- matic paging is preferred.
gestions and requests is considered inadequate. Please do not import tables or figures
into the text document, but only specify their didactic or military degrees; full name of the
insertion in text (e.g. Table No3 insertion). working-place (institution and department) for
They have to be sent in separate files. Files each author; contact details of the correspond-
should be labeled with appropriate and descript- ing author (full address, telephone number, fax
ive file names, without diacritics (e.g. Popescu number, e-mail address) and the address of the
Imunofluorescenta.doc, Popescu Imunofluores- institution and department where the study has
centa Fig1.tiff, Popescu Imunofluorescenta been carried out. Contact details will be pub-
Table2.doc). lished unless otherwise requested by the author.
Resolution of scanned images must be Page 3: Abstract page.
at least 300 dpi at the size they will appear in The abstract should have no more than
the print and there must be no scanning faults 250 words and describe briefly the purpose of
(e.g. shadows, malrotation). The preferred the study, methods and procedures used, the
format for digital images files is TIFF (Tagged most important results, main conclusions, new
Image File Format). JPEG (Joint Photographic aspects and importance of the study. Key
Experts Group) format can be used for photo- words (at least 3) according to Index medicus.
graphs if the image is saved with minimum Pages 4 and next:
compression. Please do not save digital files in The text of original papers will be or-
GIF (Graphics Interchange Format) format. ganized in: introduction (no more than 25% of
Any special instructions regarding sizing should the text), material and methods, results, com-
be clearly noted. Authors should state the color- ments or discussions and acknowledgements.
ation technique and the magnification factor of Material and methods have to be described in
all images of microscopic samples. enough detail to permit reproduction by other
The author will be required to bear the teams. The same product names should be used
cost of publication of color illustrations, if the throughout the text (with the brand name in par-
number of these exceeds two color figures (in- enthesis at the first use). Results should be
vited contributions excepted). The charge is 60 presented concisely. Tables and figures should
RON (15 EUR) for each color figure, starting not duplicate text. The discussion should set
with the third illustration). the results in context and set forth the major
All payments will be operated in conclusions of the authors. Information from
RO56BRDE270SV16682302700 bank account the Introduction or Results should not be re-
open for Romanian Association of Medical peated unless necessary for clarity. The discus-
Laboratories CF 17383407 at BRD-Groupe sion should also include a comparison among
Socit Gnrale SA, Agenia Petru Maior, Str. the obtained results and other studies from the
Mihai Viteazu 31, Trgu Mure. Please fax a literature, with explanations or hypothesis on
copy of the bank draft at the Editorial Secretari- the observed differences, comments on the im-
at ( +40 265 217 425). portance of the study and the actual status of the
investigated subject, unsolved problems, ques-
Manuscript organization tions to be answered in the future. In addition to
the customary recognition of non-authors who
Text will be structured on separate have been helpful to the work described, the ac-
pages, as follows:
knowledgements section must disclose any
Page 1: Title of the paper, having no substantive conflicts of interest.
more than 150 characters, with no abbrevi-
Abbreviations shall be preceded by the
ations. full term at their first apparition in text. A list of
Page 2: First name, middle initiale and all used abbreviations shall be made at the end
surname of the authors, without any scientific,
of the article. and completeness of all references and are also

Separate pages: tables, graphics, pic- responsible for ensuring that references are not
tures and schemes will appear on separate used out of context.
pages. For journal articles use the following
Tables will have a reasonable number form: authors surnames and first names ini-
of rows and columns. tials, articles title, the journal abbreviation ac-
Please do not forget to send the tables, cording to the Index Medicus, year, volume,
charts, schemes etc. in their original file format starting and ending pages of the article. If there
(for example, .xls files if they were created in are more than six authors, list the first six and
Microsoft Excel), and not embedded in the art- add et al.
icle text file (see Manuscript preparation sec- e.g. Zimmermann MB, de Benoist B,
tion). Corigliano S, Jooste PL, Molinari L, Moosa K,
References should be numbered con- et al. Assessment of iodine status using dried
secutively in the order in which they are first blood spot thyroglobulin: development of refer-
mentioned in the text. Identify references in ence material and establishment of an interna-
text, tables, and legends by Arabic numerals in tional reference range in iodine-sufficient chil-
parentheses. References cited only in tables or dren. J Clin Endocrinol Metab. 2006
figure legends should be numbered in accord- Dec;91(12):4881-7
ance with the sequence established by the first For books or monographs: the names of
identification in the text of the particular table the cited chapters authors, chapters title, the
or figure. The titles of journals should be abbre- editors, the books or monographs title, Edit-
viated according to the style used in Index ures name and location, the year of the appear-
Medicus. Consult the list of Journals Indexed ance and pages.
for MEDLINE, published annually as a separate
publication by the National Library of Medi-
cine. Authors are responsible for the accuracy
Revista Romn de Medicin de Laborator

Official publication of the Romanian Association of Medical Laboratories
Editorial Office:
Prof. Minodora Dobreanu
University of Medicine and Pharmacy, Trgu Mure
Dept. of Clinical Biochemistry
Str. Gh. Marinescu, Nr. 38, Trgu Mure, Romania
Tel./Fax: +40 265 217 425, E-mail: publication@almr.ro, Website: www.rrml.ro
Authorship responsibilities
Signing this form, the authors of the manuscript entitled:
__________________________________________________________________________________
__________________________________________________________________________________
guarantee that:
the corresponding author is empowered by all of the authors to act on their behalf with re-
spect to the submission of the manuscript;
the article, as submitted, has been reviewed by and approved by all named authors;
all named authors have participated substantially in the work;
all those who have participated in the work in a substantive way have been named as authors
of the paper;
the paper is original (only applies to articles reporting research results);
the article does not infringe upon any copyright or other proprietary right of any third party;
neither the text nor the data have been published previously, abstracts excepted (applies to
articles reporting research results)
the article or a substantially similar article is not under consideration by another journal at
submission time. If this can not be certified, permission from the copyright owner to republish copy-
righted material must be included with the manuscript.
The author(s), in consideration of the acceptance of the above paper for publication, does
hereby assign to the Editorial Board of the Romanian Review of Laboratory Medicine the rights to
publish the above mentioned paper, in its current form and in any form subsequently revised for public-
ation and/or electronic dissemination and they will republish/re-disseminate this material only with the
written consent from the Editor-in-Chief of the Romanian Review of Laboratory Medicine.
Authors:
Name, Signature, Date
1. ______________________________________ 5. ______________________________________
2. ______________________________________ 6. ______________________________________
3. ______________________________________ 7. ______________________________________
4. ______________________________________ 8. ______________________________________

2009 2 Supliment

Загружено:

Сведения о документе

Оригинальное название

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

2009 2 Supliment

Загружено:

Авторское право:

Доступные форматы

REVISTA ROMN DE

Under the auspices of IFCC and EFCC

24 - 27 June 2009, Trgu Mure, Romania

Romanian Association of Medical Laboratories

Automation and analytical techniques

R3. Pitfalls in the performance and interpretation of some clinical

Erori n executarea i interpretarea unor teste de imunologie clinic

R4. Inhibitors of stem cell factor binding to its receptor c-Kit -

Rspuns citogenetic i molecular dup dasatinib n leucemia mieloid

C9. Cytogenetic analysis in malignant hematologic diseases in Tg. Mure,

Analize citogenetice n hemopatiile maligne n Tg. Mure, Romnia

C10. Somatic activating mutations in myeloproliferative neoplasms as

Mutatii somatice activatoare in neoplasmele mieloproliferative ca markeri

Rolul citokinelor n creterea i supravieuirea celulelor mielomatoase

Interleukina 15 induce proliferarea i supravieuirea celulelor T i B, celulelor NK i neutrofile-

R15. Pure red cell aplasia in immunosuppressed renal transplant recipients.

Aplazie pur a seriei eritrocitare la pacieni cu transplant renal i tratament

C16. Utility of CD34 and CD117 markers in management of acute myeloid

Utilitatea markerilor CD34 i CD117 n managementul leucemiei acute

Rolul investigaiilor genetice i al cercetrii n diagnosticul bolilor rare

C20. Correlations of clinical, genetic and epigenetic in Prader-Willi

Corelaii clinice-genetice-epigenetice n sindromul Prader-Willi: Model de

din studiu, mbuntirea managementului educaional al familiei, coordonarea micrilor, auto-control

C21. Evaluations of chromosomal abnormalities diagnosed prenataly in

Studiul cromosomilor fetali din lichidul amniotic n centrul universitar

C22. The importance of chromosomal analysis in diagnosis of

Importana analizei cromosomice n diagnosticul sindroamelor

C23. Genetic testing in hereditary haemochromatosis

Testarea genetic n hemocromatoza ereditar

C24. Possibilities and challenges in the molecular diagnosis of monogenic

Posibilitile i dificultile diagnosticului molecular al afeciunilor

C25. Laboratory diagnosis of lysosomal storage diseases

Diagnosticul de laborator n bolile lizozomale

C26. Molecular genetic alterations and their predictive values in superficial

C27. Sex chromosome abnormalities the experience of the Cytogenetic

Anomalii structurale i numerice ale heterozomilor experiena

C28. Molecular Mechanisms of Spinal Muscular Atrophy

Mecanisme moleculare ale atrofiei musculare spinale

C29. Iasi Medical Genetics Centers experience concerning diagnosis and

Experiena Centrului de Genetic Medical Iai privind diagnosticul i

R32. Aspirin resistance and its laboratory diagnostics

R33. Anticoagulant mechanisms in the postoperative state

Comportarea unor mecanisme anticoagulante la pacieni n stare

Determinrile serologice n bolile transmisibile. Limite i perspective

C36. Congenital syphilis guidelines for laboratory diagnosis

Sifilisul congenital - principiile diagnosticului de laborator

C37. Antibody avidity testing and its significance in laboratory diagnosis

Testul de aviditate - semnificaii n diagnosticul de laborator

R38. Antimicrobial susceptibility testing new recommendations and

Testarea sensibilitii la antibiotice noi recomandri i implicaii n

C39. Biorisk management a new approach

Managementul bioriscului o nou abordare

C40. Characterization of the nosocomial and community-associated MRSA

C41. Staphylococcus aureus involved in bacteraemia in an emergency

Bacteriemii cauzate de Staphylococcus aureus ntr-un spital clinic judeean

C42. Bacterial ethiology and drug resistance pattern of bacteria isolated

Etiologia bacterian i farmacorezistena germenilor izolai din hemoculturi

copeptide i linezolid (100%), evideniindu-se o diferen semnificativ statistic ntre spectrul de

C43. Posterior mitral valve endocarditis accompaned by bacteraemia with

Endocardit valvular mitral posterioar nsoit de bacteriemie cu

C44. Implication of Clostridium difficile in the aetiology of hospital acquired

Implicarea Clostridium difficile n etiologia diareei intraspitaliceti

Profilul etiologic i spectrul sensibilitii la antibiotice al infeciilor urinare